WO2010051265A1 - Capacitor and inductor elements physically disposed in series whose lumped parameters are electrically connected in parallel to form a bandstop filter - Google Patents
Capacitor and inductor elements physically disposed in series whose lumped parameters are electrically connected in parallel to form a bandstop filter Download PDFInfo
- Publication number
- WO2010051265A1 WO2010051265A1 PCT/US2009/062167 US2009062167W WO2010051265A1 WO 2010051265 A1 WO2010051265 A1 WO 2010051265A1 US 2009062167 W US2009062167 W US 2009062167W WO 2010051265 A1 WO2010051265 A1 WO 2010051265A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- bandstop filter
- capacitor
- inductor
- series
- bandstop
- Prior art date
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Classifications
-
- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
- H01F27/00—Details of transformers or inductances, in general
- H01F27/02—Casings
- H01F27/027—Casings specially adapted for combination of signal type inductors or transformers with electronic circuits, e.g. mounting on printed circuit boards
-
- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01G—CAPACITORS; CAPACITORS, RECTIFIERS, DETECTORS, SWITCHING DEVICES, LIGHT-SENSITIVE OR TEMPERATURE-SENSITIVE DEVICES OF THE ELECTROLYTIC TYPE
- H01G4/00—Fixed capacitors; Processes of their manufacture
- H01G4/40—Structural combinations of fixed capacitors with other electric elements, the structure mainly consisting of a capacitor, e.g. RC combinations
-
- H—ELECTRICITY
- H03—ELECTRONIC CIRCUITRY
- H03H—IMPEDANCE NETWORKS, e.g. RESONANT CIRCUITS; RESONATORS
- H03H1/00—Constructional details of impedance networks whose electrical mode of operation is not specified or applicable to more than one type of network
- H03H1/0007—Constructional details of impedance networks whose electrical mode of operation is not specified or applicable to more than one type of network of radio frequency interference filters
-
- H—ELECTRICITY
- H03—ELECTRONIC CIRCUITRY
- H03H—IMPEDANCE NETWORKS, e.g. RESONANT CIRCUITS; RESONATORS
- H03H7/00—Multiple-port networks comprising only passive electrical elements as network components
- H03H7/01—Frequency selective two-port networks
- H03H7/0115—Frequency selective two-port networks comprising only inductors and capacitors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/08—Arrangements or circuits for monitoring, protecting, controlling or indicating
- A61N1/086—Magnetic resonance imaging [MRI] compatible leads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/37—Monitoring; Protecting
- A61N1/3718—Monitoring of or protection against external electromagnetic fields or currents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/3752—Details of casing-lead connections
- A61N1/3754—Feedthroughs
-
- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
- H01F17/00—Fixed inductances of the signal type
- H01F17/04—Fixed inductances of the signal type with magnetic core
- H01F17/06—Fixed inductances of the signal type with magnetic core with core substantially closed in itself, e.g. toroid
- H01F2017/065—Core mounted around conductor to absorb noise, e.g. EMI filter
-
- H—ELECTRICITY
- H01—ELECTRIC ELEMENTS
- H01F—MAGNETS; INDUCTANCES; TRANSFORMERS; SELECTION OF MATERIALS FOR THEIR MAGNETIC PROPERTIES
- H01F27/00—Details of transformers or inductances, in general
- H01F27/40—Structural association with built-in electric component, e.g. fuse
-
- H—ELECTRICITY
- H03—ELECTRONIC CIRCUITRY
- H03H—IMPEDANCE NETWORKS, e.g. RESONANT CIRCUITS; RESONATORS
- H03H1/00—Constructional details of impedance networks whose electrical mode of operation is not specified or applicable to more than one type of network
- H03H2001/0021—Constructional details
- H03H2001/0042—Wound, ring or feed-through type capacitor
-
- H—ELECTRICITY
- H03—ELECTRONIC CIRCUITRY
- H03H—IMPEDANCE NETWORKS, e.g. RESONANT CIRCUITS; RESONATORS
- H03H7/00—Multiple-port networks comprising only passive electrical elements as network components
- H03H7/01—Frequency selective two-port networks
- H03H2007/013—Notch or bandstop filters
Definitions
- the present invention relates to passive bandstop filter circuits wherein one or more of both inductor (L) and capacitor (C) elements are physically disposed in series but whose equivalent (lumped) L-C parameters are electrically connected in parallel.
- L-C bandstop filters may be wired in series or in parallel with the leads or circuit traces of electronic circuits as needed for the particular application, for example, military, space, medical, commercial electronics, aviation or other applications. More specifically, the present invention is particularly suitable for applications where it is important to keep the diameter or cross-sectional area of the bandstop filter relatively small.
- a particular application of the invention is directed to the bandstop filter being installed in series with medical implanted leads in order reduce the amount of radio frequency (RF) current and associated heating due to energy deposited on the leads during medical diagnostic procedures, such as magnetic resonance imaging (MRI).
- RF radio frequency
- the bandstop filter is designed to be resonant at the MRI RF pulsed frequency and thereby present a high impedance in the lead thus reducing RF current flow. Reduction of MRI induced RF current in an implanted lead prevents dangerous overheating and the associated possibility of damage to adjacent tissues.
- This invention generally relates to the problem of energy induced into implanted leads during medical diagnostic procedures such as magnetic resonant imaging (MRI).
- MRI magnetic resonant imaging
- the RF pulsed field of MRI equipment can couple to an implanted lead in such a way that electromagnetic forces (EMFs) are induced in the lead.
- EMFs electromagnetic forces
- the amount of energy that is induced is related to a number of complex factors, but in general is dependent upon the local electric field that is tangent to lead and the integral of the electric field strength along the lead.
- EMFs can cause currents to flow into distal electrodes or in the electrode interface with body tissue. It has been documented that when this current becomes excessive, overheating of said electrode or overheating of the associated interface with body tissue can occur.
- Implantable lead systems are generally associated with active implantable medical devices (AIMDs) such as cardiac pacemakers, cardioverter defibrillators, neurostimulators and the like. Implantable leads can also be associated with external devices such as external pacemakers, externally worn neurostimulators (such as pain control spinal cord stimulators) and the like.
- AIMDs active implantable medical devices
- Implantable leads can also be associated with external devices such as external pacemakers, externally worn neurostimulators (such as pain control spinal cord stimulators) and the like.
- Compatibility of cardiac pacemakers, implantable defibrillators and other types of active implantable medical devices with magnetic resonance imaging (MRI) and other types of hospital diagnostic equipment has become a major issue.
- MRI magnetic resonance imaging
- MRI is one of medicine's most valuable diagnostic tools. MRI is, of course, extensively used for imaging, but is also used for interventional medicine (surgery). In addition, MRI is used in real time to guide ablation catheters, neurostimulator tips, deep brain probes and the like.
- An absolute contra-indication for pacemaker patients means that pacemaker and implantable cardioverter defibrillator (ICD) wearers are excluded from MRI. This is particularly true of scans of the thorax and abdominal areas. Because of MRI's tremendous value as a diagnostic tool for imaging organs and other body tissues, many physicians simply take the risk and perform MRI on a pacemaker patient.
- the literature indicates a number of precautions that physicians should take in this case, including limiting the power of the MRI RF pulsed field (Specific Absorption Rate — SAR level), programming the pacemaker to fixed or asynchronous pacing mode, and then careful reprogramming and evaluation of the pacemaker and patient after the procedure is complete.
- SAR level is not entirely predictive of the heating that would be found in implanted leadwires or devices. For example, for magnetic resonance imaging devices operating at the same magnetic field strength and also at the same SAR level, considerable variations have been found relative to heating of implanted leadwires. It is speculated that SAR level alone is not a good predictor of whether or not an implanted device or its associated leadwire system will overheat.
- Bo main static magnetic field
- Bo main static magnetic field
- the field strength varies from 0.5 to 3.0 Tesla in most of the currently available MRI units in clinical use.
- Some of the newer MRI system fields can go as high as 4 to 5 Tesla.
- Certain research systems are as high as 1 1 .7 Tesla. This is over 1 00,000 times the magnetic field strength of the earth.
- a static magnetic field can induce powerful mechanical forces and torque on any magnetic materials implanted within the patient. This would include certain components within the cardiac pacemaker itself and/or lead systems. It is not likely (other than sudden system shut down) that the static MRI magnetic field can induce currents into the pacemaker lead system and hence into the pacemaker itself.
- the second type of field produced by magnetic resonance imaging is the pulsed RF field, designated Bi , which is generated by the body coil or head coil. This is used to change the energy state of the protons and elicit MRI signals from tissue.
- the RF field is homogeneous in the central region and has two main components: (1 ) the magnetic field is circularly polarized in the actual plane; and (2) the electric field is related to the magnetic field by Maxwell's equations.
- the RF field is switched on and off during scanning protocols and usually has a frequency of 21 MHz to 64 MHz to 1 28 MHz depending upon the static magnetic field strength.
- the third type of MRI electromagnetic field is the time-varying magnetic gradient fields designated Gx, GY, GZ which are used for spatial localization. These change their strength along different orientations and operating frequencies on the order of 1 to 2 kHz.
- the vectors of the magnetic field gradients in the x, y and z directions are produced by three sets of orthogonally positioned coils and are switched on only during the scanning protocols.
- VLF very low frequency
- EMFs voltages
- EMI signals are induced only into the first area of the lead system (for example, at the header block of a cardiac pacemaker). This has to do with the wavelength of the signals involved and where they couple efficiently into the system.
- MRI gradient field coupling into an implanted lead system is based on loop areas and orientation.
- a cardiac pacemaker unipolar lead there is a loop formed by the lead as it comes from the cardiac pacemaker housing to its distal tip, for example, located in the right ventricle.
- the return path is through body fluid and tissue generally from the Tip electrode in the right ventricle back up to the pacemaker case or housing.
- This forms an enclosed area which can be measured from patient X-rays in square centimeters.
- the average loop area is 200 to 225 square centimeters. This is an average and is subject to great statistical variation.
- the implanted loop area is much larger (approximately 377 square centimeters).
- the magnetic gradient fields would be induced through enclosed loop areas.
- the pulsed RF fields which are generated by the body coil, would be primarily induced into the lead system by antenna action. [Para 1 1 ]
- RF energy can be absorbed and converted to heat.
- the cause of heating in an MRI environment is twofold: (a) RF field coupling to the lead can occur which induces significant local heating; and (b) currents induced between the distal tip and tissue during MRI RF pulse transmission sequences can cause local ohmic heating in tissue next to the distal Tip electrode of the implanted lead.
- the power deposited by RF pulses during MRI is complex and is dependent upon the power (Specific Absorption Rate (SAR)) level and duration of the RF pulse, the transmitted frequency, the number of RF pulses applied per unit time, and the type of configuration of the RF transmitter coil used.
- the amount of heating also depends upon the volume of tissue imaged, the electrical resistivity of tissue and the configuration of the anatomical region imaged.
- Pad electrodes are very common in neurostimulator applications.
- spinal cord stimulators or deep brain stimulators can include a plurality of Pad electrodes to make contact with nerve tissue.
- a good example of this also occurs in a cochlear implant.
- In a typical cochlear implant there would be sixteen Ring electrodes placed up into the cochlea. Several of these Ring electrodes make contact with auditory nerves.
- MRI patients with active implantable medical devices, such as cardiac pacemakers can be at risk for potential hazardous effects
- MRI can be safe for imaging of pacemaker patients when a number of precautions are taken (only when an MRI is thought to be an absolute diagnostic necessity).
- Distal Tip electrodes can be unipolar, bipolar and the like. It is very important that excessive current not flow at the interface between the distal Tip electrode and body tissue. In a typical cardiac pacemaker, for example, the distal Tip electrode can be passive or of a screw-in helix type. In any event, it is very important that excessive RF current not flow at this junction between the distal Tip electrode and for example, myocardial or nerve tissue. This is because tissue damage in this area can raise the capture threshold or completely cause loss of capture. For pacemaker dependent patients, this would mean that the pacemaker would no longer be able to pace the heart. This would, of course, be life threatening for a pacemaker dependent patient. For neurostimulator patients, such as deep brain stimulator patients, the ability to have an MRI is equally important.
- US 2007/01 1 2398 Al relates generally to L-C bandstop filter assemblies, particularly of the type used in active implantable medical devices (AIMDs) such as cardiac pacemakers, cardioverter defibrillators, neurostimulators and the like, which raise the impedance of internal electronic or related wiring components of the medical device at selected frequencies in order to reduce or eliminate currents induced from undesirable electromagnetic interference (EMI) signals.
- AIMDs active implantable medical devices
- EMI undesirable electromagnetic interference
- the bandstop filter when placed at the distal tip of a pacemaker leadwire, will significantly reduce RF currents from flowing through the distal tip and into body tissue. It will be obvious to those skilled in the art that all of the embodiments described in U. S. Patent 7,363,090 are equally applicable to a wide range of other implantable and external medical devices, including deep brain stimulators, spinal cord stimulators, drug pumps, probes, catheters and the like.
- leads are placed at locations in the human body primarily by one of two main methods.
- the first is guide wire endocardial lead insertion.
- a pectoral pocket is created and then the physician makes a small incision and accesses the cephalic or subclavian vein.
- the endocardial pacemaker leads are stylus guided/routed down through this venous system through the right atrium, through the tricuspid valve and into, for example, the right ventricle.
- a second primary method of installing leads (particularly for neurostimulators) in the human body is by tunneling.
- the present invention relates to passive bandstop filter circuits wherein one or more of both inductor (L) and capacitor (C) elements are physically disposed in series but whose equivalent (lumped) LC parameters are electrically connected in parallel.
- the bandstop filter comprises an inductor having first and second conductive terminals in spaced non-conductive relation, and a capacitor having first and second conductive terminals in spaced non-conductive relation, wherein the inductor and the capacitor are physically disposed in series relative to one another, and wherein the inductor and the capacitor are electrically connected to one another in parallel.
- one of the first or second conductive terminals of the inductor is disposed generally adjacent to one of the first or second conductive terminals of the capacitor. Such an arrangement results in the capacitor and the inductor being aligned along a common axis. In preferred embodiments, the adjacent conductive terminals of the inductor and the capacitor abut one another. However, if the electrical potential of the adjacent surfaces has not been minimized or zeroed, an electrical insulator may be disposed between the adjacent conductive terminals of the inductor and the capacitor.
- the inductor comprises a chip inductor
- the capacitor comprises a chip capacitor.
- the second conductive terminal of the inductor is preferably conductively coupled to the first conductive terminal of the capacitor, and the first conductive terminal of the inductor is conductively coupled to the second conductive terminal of the capacitor, all the while the inductor and the capacitor being physically disposed in series relative to one another.
- the parallel capacitor and inductor may be disposed in series in an electrical lead or circuit trace.
- the capacitor and the inductor may be tuned to impede induced current flow through the electrical lead at a selected frequency.
- the electrical lead comprises a portion of an implanted lead for a medical device.
- the electrical lead may include an active fixation tip, wherein the bandstop filter is disposed within the active fixation tip.
- the bandstop filter may further comprise a plurality of paired inductors and capacitors, wherein in each paired inductor and capacitor, the inductor and the capacitor are physically disposed in series relative to one another and yet electrically connected to one another in parallel. Each paired inductor and capacitor may further be electrically connected in series to another paired inductor and capacitor.
- the parallel capacitor and inductor are disposed in parallel between two electrical leads or circuit traces.
- the capacitor and the inductor are tuned to divert induced current flow through the electrical leads except at a selected frequency.
- the capacitor and the inductor may be comprised of biocompatible and non-migratable materials.
- the inductor, the capacitor, and all associated electrical connections, and support substrates, if any, may comprise biocompatible materials to form a biocompatible package suitable for mammalian implantation.
- elements of the capacitor and/or the inductor comprise non-biocompatible materials, they may be disposed within a hermetically sealed container.
- the hermetically sealed container comprises a biocompatible housing in which the bandstop filter is disposed, and biocompatible first and second conductive contacts extending through the housing which are conductively coupled in series to the bandstop filter.
- the hermetically sealed container may be disposed in series in the electrical lead, and the first and second contacts may be connected to, respectively, first and second portions of the lead.
- a substrate is provided onto which the inductor and the capacitor are fixed in a pre-assembly prior to insertion into the biocompatible housing.
- the pre-assembly is tested prior to insertion into the biocompatible housing, and after the pre-assembly is inserted into the biocompatible housing, hermetical terminals comprising at least a portion of the first and second conductive contacts are hermetically sealed to the housing.
- the inductor comprises a plurality of inductors which may be conductively coupled to one another either in series or in parallel.
- the plurality of inductors are physically disposed in series relative to one another.
- the capacitor may comprise a plurality of capacitors conductively coupled to one another either in series or in parallel.
- the plurality of capacitors is physically disposed in series relative to one another.
- the values of the inductor and the capacitor are selected such that the bandstop filter is resonant at a selected frequency.
- the overall Q of the bandstop filter is selected to balance impedance at the selected frequency versus frequency bandwidth characteristics. This may be accomplished when the Q of the inductor is relatively high and the Q of the capacitor is relatively low, such as when the inductor has a relatively low resistive loss and when the capacitor has a relatively high equivalent series resistance. Alternatively, this may also be accomplished when the Q of the inductor is relatively low and the Q of the capacitor is relatively high, which is accomplished when the inductor has a relatively high resistive loss and the capacitor has a relatively low equivalent series resistance.
- the selected frequency may comprise an MRI pulsed frequency, and the overall Q of the bandstop filter may be selected to attenuate current flow along a lead or circuit trace through a range of selected frequencies.
- the inductor and the capacitor may be mounted on a flexible substrate, which itself may include portions that are wrapped around the capacitor and the inductor during the assembly process.
- a wrapped assembly is disposed within a protective container such as a hermetically sealed biocompatible housing.
- the inductor is disposed on a first surface of an intermediate substrate, and the capacitor is disposed on a second generally opposite surface of the intermediate substrate.
- Circuit traces extend through the intermediate substrate and conductively couple the inductor and the capacitor in parallel.
- all of the aforementioned assemblies may be formed utilizing robotic manufacturing techniques wherein the inductor and the capacitor are robotically deposited on the substrate.
- the substrate itself may comprise a multi-layered flex cable.
- FIGURE 1 is a wire-formed diagram of a generic human body showing a number of exemplary medical devices.
- FIGURE 2 is an elevational view of a typical prior art cardiac pacemaker showing the metal case and an IS-I header block.
- FIGURE 3 is a perspective view of the cardiac pacemaker of FIG. 2, with exemplary associated leads to the heart.
- FIGURE 4 is a schematic illustration of a bipolar leadwire system with a distal Tip and ring typically as used with a cardiac pacemaker.
- FIGURE 5 is a schematic illustration of a prior art single chamber bipolar cardiac pacemaker lead showing the distal Tip and the distal Ring electrodes.
- FIGURE 6 is an enlarged, fragmented schematic view taken generally along the line 6-6 of Fig. 5, illustrating placement of bandstop filters adjacent to the distal tip and Ring electrodes.
- FIGURE 7 is a cross-sectional view of a generic prior art active fixation distal tip typically used in conjunction with cardiac pacemakers.
- FIGURE 8 is a schematic diagram of a distal Tip electrode tank circuit or bandstop filter.
- FIGURE 9 is a graph showing impedance versus frequency for the parallel tank circuit of FIG. 8.
- FIGURE 10 is a schematic illustration of a unipolar AIMD lead system with a bandstop filter disposed near the distal electrode.
- FIGURE 1 1 is a graph of attenuation versus frequency for capacitors having high, medium and low Q.
- FIGURE 1 2 is a schematic illustration of a bipolar AIMD wherein multiple bandstop filters are disposed in series with each one of the leads.
- FIGURE 1 3 is a schematic illustration of bipolar AIMD leads wherein a bandstop filter is disposed between the leads to form a diverter circuit.
- FIGURE 14 is a perspective view of a hermetically sealed L-C bandstop filter assembly embodying the present invention.
- FIGURE 1 5 is an illustration of how small the hermetically sealed assembly of FIG. 1 4 is in comparison with a U. S. one-cent coin.
- FIGURE 1 6 is a cross-sectional view taken generally along the line
- FIGURE 1 7 is a perspective view of a hermetic terminal shown in
- FIGS. 14 and 1 are identical to FIGS. 14 and 1 6.
- FIGURE 1 8 is a sectional view of the hermetic terminal taken generally along the line 1 8-1 8 from FIG. 1 6.
- FIGURE 1 9 is an elevational view taken generally along the line 1 9-
- FIGURE 20 is a perspective view illustrating a multilayer flex cable onto which a chip capacitor and a chip inductor are mounted in accordance with the present invention.
- FIGURE 21 is an electrical/physical schematic of the bandstop filter assembly of FIGS. 1 6 and 20, illustrating non-preferred conductive pathways and electrical connections to the serially arranged capacitor and inductor.
- FIGURE 22 is a purely electrical schematic of the bandstop filter of
- FIGS. 1 6 and 20 are identical to FIGS. 1 6 and 20.
- FIGURE 23 is a perspective view of an alternative construction of the bandstop filter wherein the chip inductor and chip capacitor are mounted on a flexible circuit substrate.
- FIGURE 24 is a perspective view of the assembly of FIG. 23, wherein the circuit substrate is folded up for insertion into a protective housing or container.
- FIGURE 25 is a top plan view of another alternative embodiment, wherein the serial inductor and capacitor are electrically connected in parallel in accordance with the non-preferred method shown in FIG. 21 , and wherein an electrical insulator is disposed between adjacent ends of the inductor and the capacitor.
- FIGURE 26 illustrates yet another embodiment, wherein the serial capacitor and inductor are situated on opposite sides of an intermediate substrate.
- FIGURE 27 is an exploded perspective view of the bandstop filter assembly of FIGS. 1 6 and 20, illustrating a preferred arrangement for electrically connecting the inductor and capacitor in parallel while they are physically arranged in series.
- FIGURE 28 is an electrical/physical schematic similar to FIG. 21 , illustrating preferred conductor pathways and electrical connections to the serially arranged capacitor and inductor shown in FIG. 27.
- FIGURE 29 illustrates another embodiment where two bandstop filters are placed in series with one another within a hermetically sealed container.
- FIGURE 30 is a purely electrical schematic of the dual bandstop filter assembly of FIG. 29.
- FIGURE 31 is an electrical/physical schematic similar to FIGS. 21 and 28, illustrating preferred conductive pathways and electrical connections for the dual bandstop filter assembly of FIGS. 29 and 30.
- FIGURE 32 is a perspective sectional view illustrating yet another embodiment where three inductors are physically placed in series with a single capacitor and yet electrically connected to the capacitor in parallel.
- FIGURE 33 is an electrical/physical schematic diagram of the connections between the inductors and the capacitors of FIG. 32.
- FIGURE 34 is a purely electrical schematic of the assembly of FIGS.
- FIGURE 35 is an exploded perspective view of the assembly of FIG.
- FIGURE 36 is an electrical/physical schematic diagram similar to
- FIG. 33 but illustrating three inductors and a single capacitor all electrically conducted in parallel.
- FIGURE 37 is a purely electrical schematic of the assembly of
- FIG.36 is a diagrammatic representation of FIG.36.
- FIGURE 38 is an electrical/physical schematic diagram similar to
- FIGS. 33 and 36 but illustrating two capacitors and a single inductor all electrically connected in parallel.
- FIGURE 39 are equivalent electrical schematics for the assembly of
- FIGURE 40 is an electrical/physical schematic diagram similar to
- FIG. 38 but illustrating two capacitors electrically connected in series, and then collectively electrically connected in parallel with a single inductor.
- FIGURE 41 are equivalent electrical schematics for the assembly of
- FIGURE 42 is a fragmented perspective view of a passive electrode typically used in cardiac pacemaker applications.
- FIGURE 43 is a fragmented perspective view of an active fixation tip.
- FIGURE 44 is an enlarged, fragmented sectional view taken generally along the line 44-44 from FIG. 43, illustrating placement of a bandstop filter in accordance with the present invention in series with an electrical lead for a medical device.
- the present invention is directed to miniature inductor and chip components which are physically arranged in series, but electrically connected to one another in parallel to form tank circuits and bandstop filters for impeding or diverting currents induced by electromagnetic interference, for example, in a lead or an electrode of a medical device.
- bandstop filters may be placed electrically in series with an implanted lead or electrode of an active implantable medical device (AIMD), and in a variety of other electronics circuits used in commercial electronics, military, aerospace or other applications, where it may serve as an impeder at certain resonant frequencies.
- the bandstop filter of the present invention may also be placed electrically in parallel between leads or circuit traces where it may serve as a RF current diverter at the resonant frequency.
- FIGURE 1 is a wire formed diagram of a generic human body showing a number of active implantable and external medical devices 1 00 that are currently in use.
- 10OA represents a family of hearing devices which can include the group of cochlear implants, piezoelectric sound bridge transducers and the like.
- 1 0OB represents a variety of neurostimulators and brain stimulators.
- Neurostimulators are used to stimulate the Vagus nerve, for example, to treat epilepsy, obesity and depression.
- Brain stimulators are pacemaker-like devices and include electrodes implanted deep into the brain for sensing the onset of the seizure and also providing electrical stimulation to brain tissue to prevent the seizure from actually occurring.
- the leads associated with a deep brain stimulator are often placed using real time MRI imaging.
- I OOC shows a cardiac pacemaker which is well-known in the art.
- 1 0OD includes the family of left ventricular assist devices (LVAD's), and artificial hearts, including the recently introduced artificial heart known as the Abiocor.
- 1 0OE includes an entire family of drug pumps which can be used for dispensing of insulin, chemotherapy drugs, pain medications and the like.
- Insulin pumps are evolving from passive devices to ones that have sensors and closed loop systems. That is, real time monitoring of blood sugar levels will occur. These devices tend to be more sensitive to EMI than passive pumps that have no sense circuitry or externally implanted leadwires.
- 10OF includes a variety of bone growth stimulators for rapid healing of fractures.
- I OOG includes urinary incontinence devices.
- 1 0OH includes the family of pain relief spinal cord stimulators and anti-tremor stimulators. 10OH also includes an entire family of other types of neurostimulators used to block pain.
- 1 001 includes a family of implantable cardioverter defibrillators (ICD) devices and also includes the family of congestive heart failure devices (CHF). This is also known in the art as cardio resynchronization therapy devices, otherwise known as CRT devices.
- ICD implantable cardioverter defibrillators
- CHF congestive heart failure devices
- This is also known in the art as cardio resynchronization therapy devices, otherwise known as CRT devices.
- 1 0OJ illustrates an externally worn pack. This pack could be an external insulin pump, an external drug pump, an external neurostimulator or even a ventricular assist device.
- 1 0OK illustrates the insertion of an external probe or catheter.
- FIGURES 2 and 3 are drawings of a typical cardiac pacemaker 10OC showing a titanium case or housing 102 and an IS-I header connector block
- the titanium case or housing 1 02 is hermetically sealed, however there is a point where leadwires 1 06 must ingress and egress a hermetic seal. This is accomplished by providing a hermetic terminal assembly 1 08 that generally consists of a ferrule 1 1 0 which is laser welded to the titanium housing 1 02 of the AIMD 1 0OC.
- leadwire pair 1 06a and 1 06b four leadwires are shown consisting of leadwire pair 1 06a and 1 06b and leadwire pair 1 06c and 1 06d. This is typical of what is known as a dual chamber bipolar cardiac pacemaker.
- the IS-I connectors 1 1 2 and 1 1 2' of leads 1 1 4 and 1 14' are designed to plug into receptacles 1 1 6 and
- the receptacles 1 1 6 and 1 1 6' are low voltage (pacemaker) connectors covered by an ANSI/AAMI ISO standard IS-I .
- Higher voltage devices such as implantable cardioverter defibrillators (ICDs), are covered by ANSI/AAMI ISO standard DF-I .
- ICDs implantable cardioverter defibrillators
- a new standard which will integrate both high voltage and low voltage connectors into a miniature in-line quadripolar connector is known as the IS-4 series.
- the implanted leads 1 14 and 1 14' are typically routed in a pacemaker application down into the right atrium 1 1 8 and the right ventricle 1 1 8' of the heart 1 20.
- New generation biventricular devices may introduce leads to the outside of the left ventricle, which devices have proven to be very effective in cardiac resynchronization and treating congestive heart failure (CHF).
- CHF congestive heart failure
- An RF telemetry pin antenna 1 22 is also shown which is not electrically connected to the leadwires 106 or the receptacles 1 1 6.
- the RF telemetry pin antenna 1 22 acts as a short stub antenna for picking up telemetry (programming) signals that are transmitted from the outside of the device l OOC.
- FIGURE 4 illustrates a prior art single chamber bipolar device 10OC and lead system 1 1 4 and 1 14' with a distal Tip electrode 1 24 and a Ring electrode 1 26 typically as used with the cardiac pacemaker 10OC.
- FIGURE 5 illustrates a single chamber bipolar cardiac pacemaker 1 0OC, and leads 1 14 and 1 1 4 1 having distal Tip 1 24 and distal Ring 1 26 electrodes. This is a spiral wound (coaxial) system where the Ring coil 1 1 4' is wrapped around the Tip coil 1 14. There are other types of pacemaker leadwire systems in which these two leads lay parallel to one another (known as a bifilar lead system), which are not shown.
- FIGURE 6 is an enlarged schematic illustration of the area "6-6" in FIG. 5.
- bandstop filters 1 28 and 1 28' have been placed in series with each of the respective Ring and Tip circuits.
- the Ring circuit wire 1 14' has been drawn straight instead of coiled for simplicity.
- the bandstop filters 1 28 and 1 28' are tuned such that, at an MRI pulsed RF frequency, a high impedance will be presented thereby reducing or stopping the flow of undesirable MRI induced RF current from the electrodes 1 24 and 1 26 into body tissues.
- the Tip electrode 1 24 is designed to be inserted into intimate contact with myocardial tissue. Over time it becomes encapsulated and fully embedded or buried within such tissue. However, the Ring electrode 1 26 is designed to float within the blood pool, for example, in the ventricle 1 1 8' or atrium 1 1 8. With the constant blood perfusion, the Ring electrode 1 26 is somewhat cooled during medical diagnostic procedures, such as MRI. However, the Tip electrode 1 24, which is embedded in the myocardial tissue, is thermally insulated in comparison. Moreover, it can't always be assumed that a Ring electrode 1 26 that is floating in the blood pool will be adequately cooled by the flow of blood. There are certain types of patients that have cardiovascular diseases that lead to very low blood flow rates and perfusion issues.
- the Ring electrode 1 26 can also become encapsulated by body tissues. Accordingly, both the distal Tip electrode 1 24 and the Ring electrode 1 26 are preferably both associated with bandstop filters 1 28 and 1 28'. However, since the operation of the bandstop filter 1 28 is more important with the Tip electrode 1 24 than it is with the Ring electrode 1 26 in order to prevent distal tip heating and associated tissue damage, in many cardiac applications only a Tip bandstop filter 1 28 may be required for MRI compatibility.
- FIGURE 7 is a cross-sectional view of a generic prior art active fixation distal tip 1 30 which is typically used in conjunction with cardiac pacemakers.
- a metallic housing 1 32 which contains a sharp tipped distal helix coil 1 34.
- This helix coil 1 34 is shown in its retracted position, which enables the physician to insert the fixation tip assembly 1 30 endocardially through the venous system, through the atrium, and through the tricuspid valve into the right ventricle so it does not snag or tear any tissue, and is designed to be extended and screwed into myocardial tissue. .
- the physician then turns leadwire spline assembly 1 36 in a clockwise rotation.
- a torque tool is generally applied so that the physician can twist or screw the helix coil 1 34 into place.
- Protrusion 1 38 acts as a gear so that as helix coil 1 34 is turned, it is screwed forward. This makes for a very reliable fixation into myocardial tissue.
- the helix coil 1 34 is generally attached by a laser weld 140 to an end of the spline assembly 1 36 as shown. Attached to spline assembly 1 36, usually by laser welding, is the lead 1 14 coming from the AIMD.
- FIGURE 8 is the schematic diagram of a distal tip bandstop filter circuit 1 28 that can be inserted in series generally in location 144 in FIG. 7, as described in US 2007/01 1 2398 Al .
- the inductor element L 146(L) and the capacitor element 1 48(C) be hermetically enclosed and also mechanically protected. Accordingly, they are typically installed in a hermetically sealed mechanically robust enclosure. However, these components must be very small in diameter to keep the lead and its associated distal tip small enough for insertion into various body tissues.
- FIGURE 9 is a graph showing impedance versus frequency for the ideal parallel bandstop filter circuit 1 28 of FIG. 8. As one can see, using ideal (zero resistance) circuit components, the impedance measured between the lead 1 1 4 and the helix coil 1 34 is zero until one approaches the resonant frequency f r . At the frequency of resonance, these ideal components (the parallel inductor 146 and capacitor 1 48) combine together to approach an infinite impedance.
- FIGURE 1 0 is a drawing of a generic unipolar AIMD 1 00 and lead 1 14, with the bandstop filter 1 28 added at or near the distal electrodel 34.
- the inductor 1 46 has a resistance element RL in series with it.
- the capacitor 1 48 also has a resistance Rc in series with it.
- the resistances RL and Rc can be separate discrete resistors or they are losses of the inductor and capacitor elements themselves. In general, the resistance RL will be the resistance of the circuit traces or wires used to form the inductor 146.
- the capacitor 148 has ohmic losses Rc due to the resistance of its internal electrode plates, connection to its electrode plates, and dielectric losses.
- the bandstop filter circuit 1 28 illustrated in FIG. 1 0 is a "real" bandstop filter in that the resistive losses are included. This makes it distinct from the ideal bandstop filter circuit 1 28 shown in FIG. 8. The presence of the bandstop filter 1 28 will present a very high impedance at a specific MRI RF pulse frequency to prevent currents from circulating through the distal electrode 1 34 into body tissue at this specific frequency.
- FIGURE 1 1 is a family of curves 1 50, 1 52 and 1 54 which show the attenuation in dB versus frequency for the bandstop filters 1 28 of the present invention.
- Curve 1 50 represents the use of very high Q inductor and capacitor components. If the capacitor and the inductor were ideal, meaning that they would both have zero resistance, then there would be no 3 db bandwidth at all between points "a” and "b". However, since in the real world both the inductor and the capacitor do have losses, a 3 db bandwidth separation between points "a” and “b” is achieved. It is very important that there be suitable bandwidth for two reasons: one, the MRI machine has gradient fields which change the RF frequency.
- Attenuation curves 1 54 or 1 56 shown in FIG. 1 1 are generally preferred. One can do this by controlling the relative Q of the inductor and the capacitor components of the bandstop filter 1 28.
- the Q of the inductor would be relatively low and the Q of the capacitor would be relatively high. This means that the inductor would have a relatively high internal resistance and the capacitor would have a relatively low equivalent series resistance. This is achieved by using multiple turns of relatively small wire to create a high DC resistance in the inductor, and by using multiple and robust electrode plates to keep the equivalent series resistance (ESR) of the capacitor relatively low.
- ESR equivalent series resistance
- the values of the inductor and the capacitor selected are such that the bandstop filter 1 28 is resonant at a selected frequency, and preferably selected to attenuate current flow through the lead or electrode along a range of selected frequencies. Such a frequency or range of frequency may include an MRI pulsed frequency.
- a frequency or range of frequency may include an MRI pulsed frequency.
- the Q of the inductor is relatively low or moderate, and the Q of the capacitor is relatively high or moderate to select the overall Q of the bandstop filter. That is, the inductor has a relatively high resistive loss RL, and the capacitor has a relatively low equivalent series resistance Rc.
- FIGURE 1 2 illustrates a generic bipolar AIMD 1 00, meaning that it has two implanted leads 1 14 and 1 1 4'. Shown are multiple bandstop filters 1 28, 1 28' in series with each one of the leads 1 14 and 1 1 4'.
- lead 1 14 has two bandstop filters 1 28 connected in series. As mentioned in US 2007/01 1 2398 Al , these could be designed to resonate at two different frequencies, thereby providing attenuation to the RF pulse fields of both 1 .5 Tesla and 3 Tesla MRI scanners.
- the individual bandstop filters 1 28 in lead 1 1 4 could be designed to be resonant at 64 MHz (Fn) and 1 28 MHz (Fr2), respectively.
- FIGURE 1 3 shows two circuit traces or leads 1 14 and 1 1 4', and the novel bandstop filter 1 28 of the present invention wired in parallel between the circuit traces or leads 1 14 and 1 1 4'.
- the bandstop filter 1 28 becomes an RF current diverter instead of an RF current impeder.
- the implanted leads and their associated electrodes at the distal tips be very small. It is particularly important that the cross-sections or diameters of the bandstop filters be very small for easy endocardial insertion into the venous system of the human body.
- the present invention meets these criteria by using a novel combination of components that are mechanically mounted in series, but whose lumped elements are electrically in parallel.
- the components generally consist of commercial off-the-shelf miniature chip capacitor and inductor components. These are generally manufactured in high volume throughout the world. Accordingly, they are very inexpensive, but more importantly, they are very small in size.
- micro-robotic manufacturing is the preferred method of manufacturing the novel components assemblies of the present invention, wherein the components typically are delivered on tape and reel and fed into the robots which pick and place the components and then go through a series of steps including additional component placement, wave soldering, cleaning, automatic optical inspection and automated electrical testing.
- the bandstop filters of the present invention should be small and placed in series with the implanted lead or electrode of the medical device. In such applications, it is necessary that the bandstop filter itself or a container therefor be biocompatible and highly reliable. Although commercial off-the-shelf capacitor and inductor components are very small in size, arranging them such that they are electrically coupled and likewise physically placed in parallel can increase the size of the bandstop filter where complications can arise in the placement and use of the implanted lead or electrode.
- the inductor and capacitor elements can be constructed to be completely biocompatible. In this case it would be not necessary to place them in a biocompatible hermetic container. This would have great advantages in further reducing both size and cost.
- US 2009-01 1 61 67, published May 7, 2009, and US 2009- 0259265, published October 1 5, 2009, are herein incorporated by reference.
- FIG. 14 illustrates an hermetically sealed container 1 56 having the inductor (L) and capacitor (C) components installed therein in series with one another, but whose lumped L and C elements are coupled electronically in parallel, so as to form one or more bandstop filters.
- the hermetically sealed containerl 56 is very small in diameter or cross-section and can be disposed between portions of an implantable lead 1 14, within an electrode assembly, etc.
- FIGURE. 1 5 shows the exemplary hermetically sealed container 1 56 adjacent to a United States penny or one- cent coin 1 58.
- FIGURE. 1 6 is a cross-sectional view taken generally along line 1 6- 1 6 of FIG. 1 4 and shows the various component parts of the hermetically sealed container 1 56.
- the container 1 56 comprises a housing 1 60 which is biocompatible.
- the housing 1 60 can be comprised of a biocompatible metal or alloy, such as titanium, platinum, platinum-iridium, gold, silver, etc., or a non-metallic material such as sapphire, ruby, alumina, ceramic, etc.
- the inductor 1 46 and the capacitor 148 are disposed on a substrate 1 62 and physically arranged in series, or end-to-end, with one another yet conductively or electronically coupled to one another in parallel.
- Circuit traces 1 64 and 1 66 are conductively coupled to the inductor 146 and capacitor 1 48 of the bandstop filter 1 28 and extend to conductive terminals 1 68 and 1 70 of hermetic seal assemblies 1 72 and 1 74.
- the conductive terminals 1 68 and 1 70 are designed to be conductively coupled to portions of the implantable lead 1 1 4 or electrode assembly, and that any conductive members which can be conductively coupled to the bandstop filter 1 28 within container 1 56 and extend therethrough in a hermetic fashion could be used.
- FIGURE 1 7 is an enlarged perspective view of the hermetic seal assembly 1 74, having the terminal 1 70 extending therethrough to a crimp, solder joint or laser weld tip 1 76.
- FIGURE 1 8 is a cross-section drawing taken along line 1 8-1 8 from FIG. 1 6.
- the terminal 1 70 is preferably of a common platinum-iridium alloy, such as 901 0 or 8020. However, any biocompatible and suitable material could be used in place of platinum-iridium.
- Gold braze 1 82 forms a hermetic seal between terminal 1 70 and insulator 1 78.
- the insulator 1 78 may be a polished sapphire, ruby, polycrystalline alumina, or even glass or a general ceramic material.
- the surface preparation process for the ceramic insulator 1 78 can be as follows: C- Axis single crystal, polycrystalline alumina (Al 203), Zirconia Stabilized Alumina and/or Yttria Tetragonal Zirconia Polycrystalline YTZP is etched using RF plasma before PVD sputtering using a biologically compatible metallic system.
- Plasma cleaning removes organic surface contamination and hydroxyl/oxides resulting in a higher energy surface. This activated surface readily forms strong covalent bonds with metallization atoms promoting robust, hermetic adhesion. Through industry standard process refinements, the resulting low stress, dense coating does not spall off or blister and improves the function and reliability of the final brazed joint.
- the outer ferrule 1 80 is also, preferably, of platinum-iridium since it's very easy to laser weld. It is also radio-opaque.
- the insulator 1 78 would be a polished sapphire. It would then go through a plasma-etch process, such as a 500 watt plasma-etch, to increase its surface roughness. Titanium lignum metallization would be a preferred sputter material for adhesion and wetting of the associated gold braze pre-forms.
- FIG. 1 7 one can see that the interior tip 1 76 of the terminals 1 68 and 1 70 has been extruded to be fitted into an aperture, socket, etc. of the conductive substrate or circuit traces 1 64 and 1 66.
- the interior tip 1 76 may have an aperture therethrough so that a crimped connection can be formed between it and the conductive substrate or circuit traces 1 64 and 1 66, and subsequently laser welded.
- the method of attachment to the interior tip 1 76 will vary in accordance with the type of attachment desired to the internal circuitry of the bandstop filter 1 28.
- the conductive terminals 1 68 and 1 70 are conductively coupled to the bandstop filter 1 28 as the associated hermetic seal assemblies 1 72 and 1 74 are slid into place and hermetically sealed by laser welding 1 86 to the housing 1 60 of the container 1 56.
- FIG. 1 6 shows the bandstop filter 1 28 comprised of the inductor 1 46 and capacitor 1 48, and the flexible circuit substrates 1 64 and 1 66 extending therefrom, attached to the terminals 1 68 and 1 70 so as to place the terminals 1 68 and 1 70 in electrical series with one another.
- the inductor 1 46 and the capacitor 1 48 although placed end-to-end and physically in series with one another, are conductively coupled electrically with one another in parallel.
- An insulating material 1 88 such as a thermal-setting non- conductive polymer, at least partially fills the remainder of the housing 1 60 to provide protection and mechanical robustness to the overall container assembly 1 56.
- This structure lends itself to a novel "ship-in-the-bottle” method of manufacturing. That is, all of the elements contained within the housing 1 60 are pre-assembled outside the housing. In particular, the terminal 1 68, the substrate 1 62 containing the inductor 146 and capacitor 148, and the opposite terminal 1 70 and the associated hermetic seals 1 72 and 1 74, are all pre- assembled outside of the overall housing 1 60. This facilitates proper electrical connections and electrical testing of the pre-assembly. In addition, this entire subassembly can go through high reliability screening. Typically, this would consist of thermal cycling or thermal shock followed by a burn-in, which means applying a relatively high voltage at elevated temperature to the circuit components and then exhaustive electrical test afterwards.
- FIGURES 1 6 and 1 9 also show an optional conformal coating 1 90 which is provided over the two gold brazes 1 82 and 1 84.
- This conformal coating 1 90 could also be applied to the entire outer surface of the housing 1 60 and a portion of terminals 1 68 and 1 70, as well as optionally over the electrical attachments to the lead system.
- This conformal coating 1 90 is important to provide electrical isolation between the two terminals 1 68 and 1 70. When directly exposed to body fluids (which contain electrolytes), gold can migrate in the presence of a voltage bias.
- pacemaker pacing pulses in saline solution can actually cause a gold electromigration or electroplating action.
- the concern is that the gold braze materials 1 82 and/or 1 84, under voltage or pulse bias, may over time migrate or deposit (electroplate) onto another surface such as the terminal 1 70 or the housing 1 60, which could negatively affect the long-term hermeticity and reliability of the hermetic seal assembly 1 74. Accordingly, the conformal coating or backfill 1 90 is placed as shown to cover both of the gold brazes 1 82 and 1 84.
- the conformal coating 1 90 may comprise thermal-setting non-conductive adhesives, silicones, parylene (which is vapor deposited), and the like, including epoxies, polyimides, polyethylene oxide, polyurethane, silicone, polyesters, polycarbonate, polyethylene, polyvinyl chloride, polypropylene, methylacrylate, para-xylylene, and polypyrrhol.
- Epo-tek H81 is considered a preferred epoxy which has already been tested for long-term biocompatibility.
- a complete conformal coating 1 90 over the entire housing 1 60 may be desirable to provide electrical isolation between the conductive terminal pins 1 68 and 1 70. This provides critical performance capability in the event of complete saturation of the housing 1 60 in saline or biological fluid. Additional performance benefits for a conformal coating 1 90 include lubricity, radiopacity, and wear resistance.
- FIGURE. 20 illustrates a multi-layer flex cable 1 92 onto which the inductor 1 46 and capacitor 148 are mounted.
- the inductor 146 is a chip inductor having first and second conductive termination surfaces 1 94 and 1 96 which are spaced from one another in non-conductive relation.
- the capacitor 1 48 also has first and second conductive termination surfaces 1 98 and 200 which are spaced apart from one another in non-conductive relation.
- the chip inductor 1 46 can be any number of chip inductor types, however the present invention is also not limited to chip inductors only.
- the inductor 146 could also be a solenoid inductor, a toroidal inductor, or any type of inductor that is known in the prior art.
- the chip capacitor 1 48 can be any number of chip capacitor types, but the present invention is not limited to chip capacitors only.
- the capacitor 1 48 may be of many different types of capacitor technologies, including film capacitors, tantalum capacitors, monolithic ceramic capacitors, electrolytic capacitors, feedthrough-type capacitors, or even tubular capacitors.
- FIG. 20 shows that the inductor 1 46 and the capacitor 1 48 are physically disposed in series relative to one another, such that they are generally aligned with one another along a common longitudinal axis and placed end-to-end. However, in accordance with the present invention, the inductor 1 46 and the capacitor 1 48 are conductively or electrically coupled to one another in parallel.
- FIGURE 22 is an electrical schematic diagram of the bandstop filter of FIGS. 20 and 21 .
- the second conductive terminal 1 96 of the inductor 146 When electrically connected as shown in FIG. 21 , the second conductive terminal 1 96 of the inductor 146 is spaced a suitable distance away from the first conductive terminal 1 98 of the capacitor 1 48.
- the reason that these termination surfaces 1 96 and 1 98 must be placed apart is that in the presence of an MRI scanner, a substantial RF voltage can be generated across this gap. Arching or even short circuits may undesirably occur. Another concern is that a long term failure may occur due to the formation of metal dendrites or whiskers. This can happen even in the presence of a low voltage bias.
- having a large physical gap between the termination surfaces 1 96 and 1 98 is generally undesirable because it increases the overall length of the bandstop filter 1 28.
- FIGURE 20 may be compared with FIG. 1 6 to see alternative configurations of the attachment between conductive terminals 1 68 and 1 70, and the conductive circuit traces or electrodes in 1 64 and 1 66.
- FIG. 1 6. illustrates a crimp configuration between the circuit traces or conductive substrates 1 64 and 1 66, and the respective tips 1 76 of the conductive terminals 1 68 and 1 70.
- FIG. 20 an alternative configuration is shown wherein the hermetic seal assemblies 1 72 and 1 74 are pre-mounted to the conductive circuit traces or substrates 1 64 and 1 66, and attached thereto by resistance welding or the like.
- FIGURE 23 illustrates an alternative embodiment wherein a flexible circuit substrate 202 is shown.
- the circuit substrate 202 includes portions which are conductive and other portions which are non- conductive, such that the conductive portions or traces of the substrate 202 place the inductor 146 and capacitor 1 48 in parallel electrical connection, although the inductor 146 and capacitor 1 48 are disposed generally end-to- end physically in series with one another.
- the substrate 202 is then folded up so that it will fit conveniently into the cylindrical housing 1 60 as previously illustrated in FIG. 1 6.
- FIGURE 25 shows another arrangement for an inductor 146 and a capacitor 1 48 physically disposed in series with one another in that they are arranged physically generally end-to-end, and yet the inductor 1 46 and the capacitor 1 48 are electrically connected in parallel to form a bandstop filter 1 28.
- a first conductive substrate or circuit trace 1 64 conductively couples the first conductive terminals 1 94 and 1 98 of the inductor 1 46 and the capacitor 1 48.
- An insulator 204 prevents conductive contact between the conductive substrate circuit trace 1 64 and the second conductive termination surface 1 96 of the inductor 1 46.
- a conductive substrate or circuit trace 1 66 is conductively coupled to and extends between the second conductive termination surface 1 96 of the inductor 1 46 and the second conductive termination surface 200 of the capacitor 1 48.
- Another insulative layer 206 is disposed adjacent to the circuit trace or substrate 1 66 to prevent electrical contact between the first conductive termination surface 1 98 of the capacitor and the circuit trace or substrate 1 66.
- Conductive coupling can be by any known means, including solders or brazes.
- An insulator or insulating material is disposed between adjacent ends of the inductor 1 46 and the capacitor 1 48 to prevent arching or short circuits from developing between the adjacent conductive termination surfaces in the presence of, for example, an MRI scanner wherein a substantial RF voltage can be generated across this gap.
- the physical/electrical schematic model for the embodiment shown in FIG. 25 is illustrated in FIG. 21 .
- FIGURE 26 illustrates an alternative embodiment wherein the inductor 1 46 and the capacitor 1 48 are disposed on generally opposite first and second surfaces of a non-conductive substrate 206. Nonetheless, the inductor 1 46 and the capacitor 1 48 are generally arranged end-to-end and in series with one another. They are merely placed on opposite sides of the non- conductive substrate 206.
- a conductive substrate or circuit trace 1 64' extends from the first conductive terminal 1 98 of the capacitor 148 and is conductively coupled to a circuit trace 1 64 extending from the first conductive terminal 1 94 of the inductor 146 by means of a conductive connection through a passageway or through hole 208 extending through the non-conductive substrate 206.
- a conductive substrate or circuit trace 1 66' extends from the second conductive terminal 1 96 of the inductor 1 46 across the non-conductive substrate 206 and is placed in conductive relation with the second conductive terminal 200 of the capacitor 148, such as by means of the conductive passage 210 which interconnects the circuit trace 1 66' with the circuit trace 1 66.
- the ends of circuit traces 1 64 and 1 66 can be coupled in series to the desired lead, electrode assembly, etc.
- FIGURES 27 and 28 are similar to FIGS. 20 and 21 , but illustrate the preferred manner of electrically attaching the inductor 1 46 and the capacitor 1 48 in parallel while simultaneously arranging them physically in series, in accordance with the present invention.
- FIG. 27 differs from FIG. 20 in that the conductive circuit traces or substrates 1 64 and 1 66 are shown with much of the insulative and overmolding material of the substrate or flex cable 1 92 (FIG. 20) removed.
- the arrangement of components illustrated in FIGS. 27 and 28 requires no space between the inductor 1 46 and the capacitor 1 48, thus minimizing the longitudinal dimensions of the bandstop filter 1 28.
- the second termination surface 1 96 of the inductor 146 is electrically shorted or at the same potential as the first termination surface 1 98 of the capacitor 1 48.
- a conductive bonding pad 214 is coupled to the conductive substrate 1 66 and conductively coupled to the second conductive terminal 200 of the capacitor 1 48.
- An insulative layer 21 6 extends between the circuit substrates 1 66 and 1 64.
- a conductive pad 21 8 comes into contact with conductive terminals 1 96 and 1 98 of the inductor 1 46 and the capacitor 1 48.
- Conductive passthroughs 220 extend from the conductive pad 21 8 through the insulative layer 21 6 and to the conductive circuit substrate 1 66 so as to place the conductive terminals 1 96 and 1 98 in conductive relation with each other and with the circuit trace or substrate 1 64.
- a non-conductive insulation layer 222 extends between circuit substrates 1 64 and 1 66 and has a conductive pad 224 on an upper surface thereof which communicates with a conductive through hole 226 to the conductive substrate 1 64, so as to place the first conductive terminal 1 94 of the inductor 146 in conductive relation and connection with the circuit substrate 1 66.
- a pre-assembly or subassembly may comprise the circuit traces, the inductor 1 46 and the capacitor 1 48 components, and the electrical connections. Then the hermetic seal assemblies 1 72 and 1 74 are attached to both ends of this rigid or flexible pre-assembly.
- FIGURES 29-31 illustrate a configuration where two bandstop filters 1 28 and 1 28' are placed in series.
- the first bandstop filter 1 28 consists of capacitor 1 48 and inductor 146.
- the second bandstop filter 1 28' consists of capacitor 248 and inductor 246.
- the first conductive substrate or circuit trace 1 64 cooperates with an intermediate internal circuit trace or conductive substrate (not shown) to conductively couple the capacitor 1 48 and the inductor 1 46 of the first bandstop filter 1 28 in parallel electrical relation with one another
- the second end circuit trace or conductive substrate 1 66 cooperates with the intermediate circuit trace or conductive substrate to place the capacitor 248 and the inductor 246 of the second bandstop filter 1 28' in parallel with one another such that the bandstop filters 1 28 and 1 28' are placed in series with one another.
- the bandstop filters 1 28 and 1 28' will be resonant at two different selective frequencies.
- the first bandstop filter 1 28 could have a self resonant frequency at 64 MHz which corresponds with a 1 .5 Tesla MRI machine.
- the second bandstop filter 1 28' could be resonant at 1 28 MHz which is the RF pulsed frequency of a 3 Tesla MRI system. Accordingly, by putting the two bandstop filters in series, the bandstop filter network of FIG. 29 would offer a high degree of attenuation to RF induced currents at both of these popular MRI frequencies.
- the bandstop filters 1 28 and 1 28' can have the same resonant frequency or approximately the same resonant frequencies.
- the advantage of having two bandstop filters in series with approximately the same resonant frequency is that this increases the attenuation of the overall bandstop filter.
- the resultant filter has the advantage of broadening the 3 dB bandwidth (see FIG. 1 1 ).
- An advantage of the configuration shown in FIG. 29 is that the slenderness ratio of the assembly can be maintained. That is, the overall diameter of the assembly must not be allowed to increase. Length is not nearly as critically important for an implantable lead, for example, for cardiac rhythm application, as is diameter. Also current handling ability is very important.
- By having two bandstop filters in series one greatly increases the overall impedance and attenuation at resonance thereby providing a much higher level of protection to adjacent body tissues.
- FIGURES 32-34 illustrate an alternative embodiment where three series inductors 146, 246 and 346 are placed in parallel with a single capacitor 1 48. It is well known in electrical engineering that when inductors are wired in series they add up. In other words, the total inductance is the sum of the three individual inductances.
- the three inductors 1 46, 246 and 346, which are in series are together in parallel with the capacitor 148, form the bandstop filter 1 28 as shown in FIG. 34.
- This arrangement has particular advantages for AIMD lead applications. This allows one to have a relatively high value of inductance while at the same time keeping the diameter or cross-sectional area very small. A disadvantage of this arrangement is that the resistive losses of the three inductors add up in series.
- the bandstop filter Q a little lower, tends to widen its 3 dB bandwidth, but also reduces its attenuation.
- the current handling ability such as during an automatic external defibrillation pulse, is also slightly compromised by the added series resistance.
- the current handling ability and/or the bandstop filter Q can be improved by using a larger wire /trace /pathway diameter or width.
- the reduction on inductance per component, compared to an inductor with the same length utilizing a smaller wire/trace/pathway diameter or width, can be compensated by the increased number of inductors.
- FIGURE 35 is an exploded perspective view of the electrical subassembly of FIG. 32. Here, one can see that it has the same circuit substrate 1 92 that was shown in FIG. 32, which includes an insulative layer 228. It will be appreciated that much of the insulation forming a portion of the circuit substrate 1 92 has been removed in FIG. 35 to better illustrate the electrical circuit traces or substrates which electrically connect the three inductors 146, 246 and 346 in series, and place them all electrically in parallel with the capacitor 1 48.
- the conductive circuit trace or substrate 1 64 extends nearly the length of the entire subassembly so as to conductively couple two both the first termination surface 1 94 of the first inductor 1 46 and to the second termination surface 200 of the capacitor 148. This is accomplished by providing a conductive pad 224a atop an insulation layer 222a, and a conductive passthrough 226a.
- the first conductive termination surface 1 94 of the first inductor 1 46 is conductively coupled to the conductive pad 224a which, in turn, conductively couples said first termination surface 1 94 to the substrate 1 64.
- the second termination surface 200 is positioned adjacent and conductively coupled to a conductive pad 224e which sits atop an insulative layer 222e.
- the conductive pad 224e is conductively coupled to the substrate 1 64 through a conductive through-hole 226d.
- two conductive pads 224b and 224c are provided which are electrically isolated from the underlying substrate 1 64 by insulative layers 222b and 222c.
- the second termination surface 1 96 of the first inductor 146 rests atop and is conductively coupled to the conductive pad 224b as is the first termination surface 294 of the second inductor 246. This arrangement conductively couples the second termination surface 1 96 of the first inductor 146 to the first termination surface 294 of the second inductor 246.
- the second termination surface 296 of the second inductor 246 rests atop a conductive pad 224c and is conductively coupled thereto, as is the first termination surface 394 of the third inductor 346.
- This arrangement conductively couples the second termination surface 296 of the second inductor 246 to the first termination surface 394 of the third inductor 346.
- the second conductive termination surface 396 of the third inductor 346 is conductively coupled to the first termination surface 1 98 of the capacitor 148 by means of a conductive pad 224d on which both termination surfaces rest and are conductively coupled thereto.
- FIGURES 36 and 37 illustrate yet another arrangement contemplated by the present invention, wherein the three inductors 1 46, 246 and 346 are placed in series with one another physically, but coupled conductively with one another in parallel.
- the capacitor 1 48 is also conductively coupled with the inductors 1 46, 246 and 346 in parallel to create a bandstop filter 1 28.
- FIGURES 38 and 39 illustrate another arrangement contemplated by the present invention, wherein two capacitors 1 48 and 248 are placed in series with one another physically but coupled conductively with one another in parallel. The capacitors are also conductively coupled with the inductor 146 in series to create a bandstop filter 1 28. Yet another alternative is illustrated in FIGS. 40 and 41 , wherein the capacitors 1 48 and 248 are disposed physically in series with one another and conductively coupled to one another in series, yet conductively coupled to the inductor L in parallel to form a bandstop filter 1 28.
- the capacitors 1 48 and 248 and the inductor 1 46 are placed end-to-end and generally disposed in series with one another yet still form a bandstop filter without increasing the overall diameter of the assembly.
- different values of the bandstop filter 1 28 may be obtained by placing multiple capacitors or inductors physically in series with one another, but in various combinations of electrical and parallel coupling to achieve the desired values.
- FIG. 43 illustrates an active fixation Tip electrode 1 30 having a helix screw 1 34 selectively extendable and retractable from the lead housing 1 32.
- the helix screw 1 34 is retracted while the lead housing 1 32 is inserted endocardially to the correct location, for example, into the right ventricle.
- the physician then uses a tool (not shown) in the pectoral pocket and twists this entire assembly which literally screws the distal helix screw 1 34 into the myocardial tissue.
- FIGURE 44 is a cross-section taken along line 44-44 from FIG.
- hermetically sealed bandstop filter assembly 1 56 Shown is the hermetically sealed bandstop filter assembly 1 56 that is embedded within the overall lead housing 1 32.
- the hermetically sealed bandstop filter assembly 1 56 can be as the assembly illustrated in FIGS. 1 4 and 1 6, or any of the other variations illustrated herein or contemplated by the present invention.
- the important aspect is that the various inductor and capacitor components be physically disposed in series relative to one another, yet conductively coupled in parallel to form one or more bandstop filters which are hermetically sealed in a biocompatible container for insertion into the electrode or leadwire of the medical device.
- the present invention relates to passive bandstop filter circuits wherein one or more of both inductor 146 and capacitor 1 48 elements are physically disposed in series but whose equivalent (lumped) L-C parameters are electrically connected in parallel.
- the disclosed embodiments are particularly suitable for applications where it is important to keep the diameter or cross-sectional area of the bandstop filter 1 28 relatively small as, for example, in medical implanted leads.
- Providing bandstop filters in such medical implanted leads serves to reduce the amount of radio frequency (RF) current associated heating due to energy deposited on the leads during medical diagnostic procedures, such as magnetic resonance imaging (MRI).
- RF radio frequency
- the bandstop filter 1 28 may be designed to be resonant at the MRI RF pulsed frequency and thereby present a high impedance in the lead thus reducing RF current flow.
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Abstract
One or more inductors and one or more capacitors are physically disposed relative to one another in series and are electrically connected to one another in parallel to form a bandstop filter. Chip inductors and chip capacitors having spaced apart conductive terminals are physically arranged in end-to-end abutting relation to minimize electrical potential between adjacent conductive terminals. The bandstop filter may be hermetically sealed within a biocompatible container for use with an implantable lead or electrode of a medical device. The values of the inductors and the capacitors are selected such that the bandstop filter is resonant at one or more selected frequencies, such as an MRI pulsed frequency.
Description
CAPACITOR AND INDUCTOR ELEMENTS PHYSICALLY DISPOSED IN SERIES WHOSE LUMPED PARAMETERS ARE ELECTRICALLY CONNECTED IN PARALLEL TO FORM A
BANDSTOP FILTER
DESCRI PTION
FIELD OF INVENTION
[Para 1 ] The present invention relates to passive bandstop filter circuits wherein one or more of both inductor (L) and capacitor (C) elements are physically disposed in series but whose equivalent (lumped) L-C parameters are electrically connected in parallel. These novel L-C bandstop filters may be wired in series or in parallel with the leads or circuit traces of electronic circuits as needed for the particular application, for example, military, space, medical, commercial electronics, aviation or other applications. More specifically, the present invention is particularly suitable for applications where it is important to keep the diameter or cross-sectional area of the bandstop filter relatively small. A particular application of the invention is directed to the bandstop filter being installed in series with medical implanted leads in order reduce the amount of radio frequency (RF) current and associated heating due to energy deposited on the leads during medical diagnostic procedures, such as magnetic resonance imaging (MRI). The bandstop filter is designed to be resonant at the MRI RF pulsed frequency and thereby present a high impedance in the lead thus reducing RF current flow. Reduction of MRI induced RF current in an implanted
lead prevents dangerous overheating and the associated possibility of damage to adjacent tissues.
BACKGROUND OF THE INVENTION
[Para 2] This invention generally relates to the problem of energy induced into implanted leads during medical diagnostic procedures such as magnetic resonant imaging (MRI). Specifically, the RF pulsed field of MRI equipment can couple to an implanted lead in such a way that electromagnetic forces (EMFs) are induced in the lead. The amount of energy that is induced is related to a number of complex factors, but in general is dependent upon the local electric field that is tangent to lead and the integral of the electric field strength along the lead. In certain situations, these EMFs can cause currents to flow into distal electrodes or in the electrode interface with body tissue. It has been documented that when this current becomes excessive, overheating of said electrode or overheating of the associated interface with body tissue can occur. There have been cases of damage to such body tissue which has resulted in loss of capture of cardiac pacemaking pulses, tissue damage severe enough to result in brain damage or multiple amputations, and the like. [Para 3] Implantable lead systems are generally associated with active implantable medical devices (AIMDs) such as cardiac pacemakers, cardioverter defibrillators, neurostimulators and the like. Implantable leads can also be associated with external devices such as external pacemakers, externally worn neurostimulators (such as pain control spinal cord stimulators) and the like.
[Para 4] Compatibility of cardiac pacemakers, implantable defibrillators and other types of active implantable medical devices with magnetic resonance imaging (MRI) and other types of hospital diagnostic equipment has become a major issue. If one goes to the websites of the major cardiac pacemaker manufacturers in the United States, which include St. Jude Medical, Medtronic and Boston Scientific (formerly Guidant), one will see that the use of MRI is generally contra-indicated with pacemakers and implantable defibrillators. [Para 5] However, an extensive review of the literature indicates that MRI is indeed often used with pacemaker, neurostimulator and other active implantable medical device (AIMD) patients. The safety and feasibility of MRI in patients with cardiac pacemakers is an issue of gaining significance. The effects of MRI on patients' pacemaker systems have only been analyzed retrospectively in some case reports. There are a number of papers that indicate that MRI on new generation pacemakers can be conducted up to 0.5 Tesla (T). MRI is one of medicine's most valuable diagnostic tools. MRI is, of course, extensively used for imaging, but is also used for interventional medicine (surgery). In addition, MRI is used in real time to guide ablation catheters, neurostimulator tips, deep brain probes and the like. An absolute contra-indication for pacemaker patients means that pacemaker and implantable cardioverter defibrillator (ICD) wearers are excluded from MRI. This is particularly true of scans of the thorax and abdominal areas. Because of MRI's incredible value as a diagnostic tool for imaging organs and other body tissues, many physicians simply take the risk and perform MRI on a pacemaker patient. The literature indicates a number of
precautions that physicians should take in this case, including limiting the power of the MRI RF pulsed field (Specific Absorption Rate — SAR level), programming the pacemaker to fixed or asynchronous pacing mode, and then careful reprogramming and evaluation of the pacemaker and patient after the procedure is complete. There have been reports of latent problems with cardiac pacemakers or other AIMDs after an MRI procedure sometimes occurring many days later. Moreover, there are a number of recent papers that indicate that the SAR level is not entirely predictive of the heating that would be found in implanted leadwires or devices. For example, for magnetic resonance imaging devices operating at the same magnetic field strength and also at the same SAR level, considerable variations have been found relative to heating of implanted leadwires. It is speculated that SAR level alone is not a good predictor of whether or not an implanted device or its associated leadwire system will overheat.
[Para 6] There are three types of electromagnetic fields produced by MRI equipment. The first type is the main static magnetic field designated Bo which is used to align protons in body tissue. The field strength varies from 0.5 to 3.0 Tesla in most of the currently available MRI units in clinical use. Some of the newer MRI system fields can go as high as 4 to 5 Tesla. Certain research systems are as high as 1 1 .7 Tesla. This is over 1 00,000 times the magnetic field strength of the earth. A static magnetic field can induce powerful mechanical forces and torque on any magnetic materials implanted within the patient. This would include certain components within the cardiac pacemaker
itself and/or lead systems. It is not likely (other than sudden system shut down) that the static MRI magnetic field can induce currents into the pacemaker lead system and hence into the pacemaker itself. It is a basic principle of physics that a magnetic field must either be time-varying as it cuts across the conductor, or the conductor itself must move within the magnetic field for currents to be induced.
[Para 7] The second type of field produced by magnetic resonance imaging is the pulsed RF field, designated Bi , which is generated by the body coil or head coil. This is used to change the energy state of the protons and elicit MRI signals from tissue. The RF field is homogeneous in the central region and has two main components: (1 ) the magnetic field is circularly polarized in the actual plane; and (2) the electric field is related to the magnetic field by Maxwell's equations. In general, the RF field is switched on and off during scanning protocols and usually has a frequency of 21 MHz to 64 MHz to 1 28 MHz depending upon the static magnetic field strength. The frequency of the RF pulse varies by the Lamor equation with the field strength of the main static field where: RF PULSED FREQUENCY in MHz = (42.56) (STATIC FIELD STRENGTH IN TESLA).
[Para 8] The third type of MRI electromagnetic field is the time-varying magnetic gradient fields designated Gx, GY, GZ which are used for spatial localization. These change their strength along different orientations and operating frequencies on the order of 1 to 2 kHz. The vectors of the magnetic field gradients in the x, y and z directions are produced by three sets of
orthogonally positioned coils and are switched on only during the scanning protocols.
[Para 9] At very low frequency (VLF), voltages are induced at the input to the cardiac pacemaker as currents circulate throughout the patient's body and create voltage drops. Because of the vector displacement between the pacemaker housing and, for example, the Tip electrode, voltage drop across the resistance of body tissues may be sensed due to Ohm's Law and the circulating current of the RF signal. At higher frequencies, the implanted lead systems actually act as antennas where voltages (EMFs) are induced along their length. These antennas are not very efficient due to the damping effects of body tissue; however, this can often be offset by extremely high power fields (such as MRI pulsed fields) and/or body resonances. At very high frequencies (such as cellular telephone frequencies), EMI signals are induced only into the first area of the lead system (for example, at the header block of a cardiac pacemaker). This has to do with the wavelength of the signals involved and where they couple efficiently into the system.
[Para 10] MRI gradient field coupling into an implanted lead system is based on loop areas and orientation. For example, in a cardiac pacemaker unipolar lead, there is a loop formed by the lead as it comes from the cardiac pacemaker housing to its distal tip, for example, located in the right ventricle. The return path is through body fluid and tissue generally from the Tip electrode in the right ventricle back up to the pacemaker case or housing. This forms an enclosed area which can be measured from patient X-rays in square
centimeters. The average loop area is 200 to 225 square centimeters. This is an average and is subject to great statistical variation. For example, in a large adult patient with an abdominal implant, the implanted loop area is much larger (approximately 377 square centimeters). Relating now to the specific case of MRI, the magnetic gradient fields would be induced through enclosed loop areas. However, the pulsed RF fields, which are generated by the body coil, would be primarily induced into the lead system by antenna action. [Para 1 1 ] At the frequencies of interest in MRI, RF energy can be absorbed and converted to heat. The cause of heating in an MRI environment is twofold: (a) RF field coupling to the lead can occur which induces significant local heating; and (b) currents induced between the distal tip and tissue during MRI RF pulse transmission sequences can cause local ohmic heating in tissue next to the distal Tip electrode of the implanted lead. The power deposited by RF pulses during MRI is complex and is dependent upon the power (Specific Absorption Rate (SAR)) level and duration of the RF pulse, the transmitted frequency, the number of RF pulses applied per unit time, and the type of configuration of the RF transmitter coil used. The amount of heating also depends upon the volume of tissue imaged, the electrical resistivity of tissue and the configuration of the anatomical region imaged. There are also a number of other variables that depend on the placement in the human body of the AIMD and its associated lead(s). For example, it will make a difference how much EMF is induced into a pacemaker lead system as to whether it is a left or right pectoral implant. In addition, the routing of the lead and the lead length
are also very critical as to the amount of induced current and heating that would occur. Also, distal Tip electrode design is very important as the distal Tip electrode itself can act as its own antenna wherein eddy currents can create heating. The RF field of an MRI scanner can produce enough energy to induce lead RF voltages and resulting currents sufficient to destroy some of the adjacent myocardial tissue. Tissue ablation has also been observed. The effects of this heating are not readily detectable by monitoring during the MRI scan. Indications that heating has occurred would include an increase in pacing threshold, venous ablation, Larynx or esophageal ablation, myocardial perforation and lead penetration, or even arrhythmias caused by scar tissue. However, these effects are typically determined some time after the scan is completed. Such long term heating effects of MRI have not been well studied yet for all types of AIMD lead geometries. There can also be localized heating problems associated with various types of electrodes in addition to Tip electrodes. This includes Ring electrodes or Pad electrodes. Ring electrodes are commonly used with a wide variety of implanted devices including cardiac pacemakers, neurostimulators and the like. Pad electrodes are very common in neurostimulator applications. For example, spinal cord stimulators or deep brain stimulators can include a plurality of Pad electrodes to make contact with nerve tissue. A good example of this also occurs in a cochlear implant. In a typical cochlear implant there would be sixteen Ring electrodes placed up into the cochlea. Several of these Ring electrodes make contact with auditory nerves.
[Para 12] Although there are a number of studies that have shown that MRI patients with active implantable medical devices, such as cardiac pacemakers, can be at risk for potential hazardous effects, there are a number of reports in the literature that MRI can be safe for imaging of pacemaker patients when a number of precautions are taken (only when an MRI is thought to be an absolute diagnostic necessity). While these anecdotal reports are of interest, they are certainly not scientifically convincing that all MRI can be safe. For example, just variations in the pacemaker lead length can significantly affect how much heat is generated. A paper entitled, HEATING AROUND INTRAVASCULAR GUIDEWIRES BY RESONATING RF WAVES by Konings, et al., Journal of Magnetic Resonance Imaging, Issue 1 2:79-85 (2000), does an excellent job of explaining how the RF fields from MRI scanners can couple into implanted leads. The paper includes both a theoretical approach and actual temperature measurements. In a worst-case, they measured temperature rises of up to 74 degrees C after 30 seconds of scanning exposure. The contents of this paper are incorporated herein by reference.
[Para 1 3] The effect of an MRI system on the function of pacemakers, ICDs, neurostimulators and the like, depends on various factors, including the strength of the static magnetic field, the pulse sequence, the strength of RF field, the anatomic region being imaged, and many other factors. Further complicating this is the fact that each patient's condition and physiology is different and each manufacturer's pacemaker and ICD designs also are
designed and behave differently. Most experts still conclude that MRI for the pacemaker patient should not be considered safe. [Para 14] It is well known that many of the undesirable effects in an implanted lead system from MRI and other medical diagnostic procedures are related to undesirable induced EMFs in the lead system and/or RF currents in its distal Tip (or Ring) electrodes. This can lead to overheating of body tissue at or adjacent to the distal Tip electrode.
[Para 1 5] Distal Tip electrodes can be unipolar, bipolar and the like. It is very important that excessive current not flow at the interface between the distal Tip electrode and body tissue. In a typical cardiac pacemaker, for example, the distal Tip electrode can be passive or of a screw-in helix type. In any event, it is very important that excessive RF current not flow at this junction between the distal Tip electrode and for example, myocardial or nerve tissue. This is because tissue damage in this area can raise the capture threshold or completely cause loss of capture. For pacemaker dependent patients, this would mean that the pacemaker would no longer be able to pace the heart. This would, of course, be life threatening for a pacemaker dependent patient. For neurostimulator patients, such as deep brain stimulator patients, the ability to have an MRI is equally important.
[Para 16] The most important and most life-threatening item is to be able to control overheating of implanted leads during an MRI procedure. A novel and very effective approach to this is to install parallel resonant inductor and capacitor bandstop filters at or near the distal electrode of implanted leads, as
described in U. S. Patent 7,363,090, and U. S. Patent Publication Nos. US 2007/01 1 2398 Al ; US 2008/0071 31 3 Al ; US 2008/0049376 Al ; US 2008/01 61 886 Al ; US 2008/01 32987 Al ; US 2008/01 1 6997 Al ; and US 2009/01 63980 Al the contents all of which are incorporated herein. US 2007/01 1 2398 Al relates generally to L-C bandstop filter assemblies, particularly of the type used in active implantable medical devices (AIMDs) such as cardiac pacemakers, cardioverter defibrillators, neurostimulators and the like, which raise the impedance of internal electronic or related wiring components of the medical device at selected frequencies in order to reduce or eliminate currents induced from undesirable electromagnetic interference (EMI) signals.
[Para 1 7] U. S. Patent 7,363,090 and US 2007/01 1 2398 Al disclose resonant L-C bandstop filters to be placed at the distal tip and/or at various locations along the medical device leadwires or circuits. These bandstop filters inhibit or prevent current from circulating at selected frequencies of the medical therapeutic device. For example, for an MRI system operating at 1 .5 Tesla, the pulsed RF frequency is 63.8 MHz, as shown by the Lamour Equation. The bandstop filter can be designed to resonate at or near 64 MHz and thus create a high impedance (ideally an open circuit) in the lead system at that selected frequency. For example, the bandstop filter, when placed at the distal tip of a pacemaker leadwire, will significantly reduce RF currents from flowing through the distal tip and into body tissue. It will be obvious to those skilled in the art that all of the embodiments described in U. S. Patent 7,363,090 are equally
applicable to a wide range of other implantable and external medical devices, including deep brain stimulators, spinal cord stimulators, drug pumps, probes, catheters and the like.
[Para 18] Electrically engineering a capacitor in parallel with an inductor is known as a tank circuit or bandstop filter. It is well known that when a near- ideal bandstop filter is at its resonant frequency, it will present a very high impedance. Since MRI equipment produces very large RF pulsed fields operating at discrete frequencies, this is an ideal situation for a specific resonant bandstop filter. Bandstop filters are more efficient for eliminating one single frequency than broadband filters. Because the bandstop filter is targeted at this one frequency, it can be much smaller and volumetrically efficient. [Para 19] However, a major challenge when designing a bandstop filter for human implant is that it must be very small in size, biocompatible, and highly reliable. Coaxial geometry is preferred. The reason that a coaxial geometry is preferred is that leads are placed at locations in the human body primarily by one of two main methods. The first is guide wire endocardial lead insertion. For example, in a cardiac pacemaker application, a pectoral pocket is created and then the physician makes a small incision and accesses the cephalic or subclavian vein. The endocardial pacemaker leads are stylus guided/routed down through this venous system through the right atrium, through the tricuspid valve and into, for example, the right ventricle. A second primary method of installing leads (particularly for neurostimulators) in the human body is by tunneling. In tunneling, a surgeon uses special tools to tunnel under the
skin and through the muscle, for example, up through the neck to access the Vagus nerve or the deep brain. In both techniques, it is very important that the leads and their associated electrodes at the distal tips be very small. [Para 20] Accordingly, there is a need for a bandstop filter for medical devices, and particularly human implanted devices and components thereof, which is very small in size, biocompatible, and highly reliable. There is also a need for such a bandstop filter which can be placed coaxially relative to a leadwire or electrode of a lead system. The present invention fulfills these needs, and provides other related advantages.
SUMMARY OF THE INVENTION
[Para 21 ] The present invention relates to passive bandstop filter circuits wherein one or more of both inductor (L) and capacitor (C) elements are physically disposed in series but whose equivalent (lumped) LC parameters are electrically connected in parallel. More particularly, the bandstop filter comprises an inductor having first and second conductive terminals in spaced non-conductive relation, and a capacitor having first and second conductive terminals in spaced non-conductive relation, wherein the inductor and the capacitor are physically disposed in series relative to one another, and wherein the inductor and the capacitor are electrically connected to one another in parallel.
[Para 22] In the illustrated embodiments, one of the first or second conductive terminals of the inductor is disposed generally adjacent to one of
the first or second conductive terminals of the capacitor. Such an arrangement results in the capacitor and the inductor being aligned along a common axis. In preferred embodiments, the adjacent conductive terminals of the inductor and the capacitor abut one another. However, if the electrical potential of the adjacent surfaces has not been minimized or zeroed, an electrical insulator may be disposed between the adjacent conductive terminals of the inductor and the capacitor.
[Para 23] As illustrated herein, the inductor comprises a chip inductor, and the capacitor comprises a chip capacitor. The second conductive terminal of the inductor is preferably conductively coupled to the first conductive terminal of the capacitor, and the first conductive terminal of the inductor is conductively coupled to the second conductive terminal of the capacitor, all the while the inductor and the capacitor being physically disposed in series relative to one another.
[Para 24] The parallel capacitor and inductor may be disposed in series in an electrical lead or circuit trace. The capacitor and the inductor may be tuned to impede induced current flow through the electrical lead at a selected frequency. Typically, the electrical lead comprises a portion of an implanted lead for a medical device. The electrical lead may include an active fixation tip, wherein the bandstop filter is disposed within the active fixation tip. [Para 25] The bandstop filter may further comprise a plurality of paired inductors and capacitors, wherein in each paired inductor and capacitor, the inductor and the capacitor are physically disposed in series relative to one
another and yet electrically connected to one another in parallel. Each paired inductor and capacitor may further be electrically connected in series to another paired inductor and capacitor.
[Para 26] In another embodiment, the parallel capacitor and inductor are disposed in parallel between two electrical leads or circuit traces. The capacitor and the inductor are tuned to divert induced current flow through the electrical leads except at a selected frequency.
[Para 27] The capacitor and the inductor may be comprised of biocompatible and non-migratable materials. In particular, the inductor, the capacitor, and all associated electrical connections, and support substrates, if any, may comprise biocompatible materials to form a biocompatible package suitable for mammalian implantation. However, when elements of the capacitor and/or the inductor comprise non-biocompatible materials, they may be disposed within a hermetically sealed container. In this case, the hermetically sealed container comprises a biocompatible housing in which the bandstop filter is disposed, and biocompatible first and second conductive contacts extending through the housing which are conductively coupled in series to the bandstop filter. In medical implant applications, the hermetically sealed container may be disposed in series in the electrical lead, and the first and second contacts may be connected to, respectively, first and second portions of the lead. In a related assembly process, a substrate is provided onto which the inductor and the capacitor are fixed in a pre-assembly prior to insertion into the biocompatible housing. The pre-assembly is tested prior to insertion into the biocompatible
housing, and after the pre-assembly is inserted into the biocompatible housing, hermetical terminals comprising at least a portion of the first and second conductive contacts are hermetically sealed to the housing. [Para 28] In several of the illustrated embodiments, the inductor comprises a plurality of inductors which may be conductively coupled to one another either in series or in parallel. However, in accordance with the present invention, the plurality of inductors are physically disposed in series relative to one another. In a similar manner, the capacitor may comprise a plurality of capacitors conductively coupled to one another either in series or in parallel. Again, in accordance with the present invention, the plurality of capacitors is physically disposed in series relative to one another.
[Para 29] The values of the inductor and the capacitor are selected such that the bandstop filter is resonant at a selected frequency. The overall Q of the bandstop filter is selected to balance impedance at the selected frequency versus frequency bandwidth characteristics. This may be accomplished when the Q of the inductor is relatively high and the Q of the capacitor is relatively low, such as when the inductor has a relatively low resistive loss and when the capacitor has a relatively high equivalent series resistance. Alternatively, this may also be accomplished when the Q of the inductor is relatively low and the Q of the capacitor is relatively high, which is accomplished when the inductor has a relatively high resistive loss and the capacitor has a relatively low equivalent series resistance. The selected frequency may comprise an MRI pulsed frequency, and the overall Q of the bandstop filter may be selected to
attenuate current flow along a lead or circuit trace through a range of selected frequencies.
[Para 30] The inductor and the capacitor may be mounted on a flexible substrate, which itself may include portions that are wrapped around the capacitor and the inductor during the assembly process. Typically, such a wrapped assembly is disposed within a protective container such as a hermetically sealed biocompatible housing.
[Para 31 ] In an illustrated embodiment, the inductor is disposed on a first surface of an intermediate substrate, and the capacitor is disposed on a second generally opposite surface of the intermediate substrate. Circuit traces extend through the intermediate substrate and conductively couple the inductor and the capacitor in parallel. Of course, all of the aforementioned assemblies may be formed utilizing robotic manufacturing techniques wherein the inductor and the capacitor are robotically deposited on the substrate. The substrate itself may comprise a multi-layered flex cable.
[Para 32] All of the illustrated embodiments are suitable for use with ultra- miniature inductor and capacitor chip components that are mechanically installed in hermetic packages in series, but have electrical circuit traces that put the components electrically in parallel, to form the desired bandstop filter having tank circuit characteristics.
[Para 33] Other features and advantages of the present invention will become apparent from the following more detailed description, taken in conjunction
with the accompanying drawings, which illustrate, by way of example, the principles of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[Para 34] The accompanying drawings illustrate the invention. In such drawings:
[Para 35] FIGURE 1 is a wire-formed diagram of a generic human body showing a number of exemplary medical devices.
[Para 36] FIGURE 2 is an elevational view of a typical prior art cardiac pacemaker showing the metal case and an IS-I header block.
[Para 37] FIGURE 3 is a perspective view of the cardiac pacemaker of FIG. 2, with exemplary associated leads to the heart.
[Para 38] FIGURE 4 is a schematic illustration of a bipolar leadwire system with a distal Tip and ring typically as used with a cardiac pacemaker.
[Para 39] FIGURE 5 is a schematic illustration of a prior art single chamber bipolar cardiac pacemaker lead showing the distal Tip and the distal Ring electrodes.
[Para 40] FIGURE 6 is an enlarged, fragmented schematic view taken generally along the line 6-6 of Fig. 5, illustrating placement of bandstop filters adjacent to the distal tip and Ring electrodes.
[Para 41 ] FIGURE 7 is a cross-sectional view of a generic prior art active fixation distal tip typically used in conjunction with cardiac pacemakers.
[Para 42] FIGURE 8 is a schematic diagram of a distal Tip electrode tank circuit or bandstop filter.
[Para 43] FIGURE 9 is a graph showing impedance versus frequency for the parallel tank circuit of FIG. 8.
[Para 44] FIGURE 10 is a schematic illustration of a unipolar AIMD lead system with a bandstop filter disposed near the distal electrode.
[Para 45] FIGURE 1 1 is a graph of attenuation versus frequency for capacitors having high, medium and low Q.
[Para 46] FIGURE 1 2 is a schematic illustration of a bipolar AIMD wherein multiple bandstop filters are disposed in series with each one of the leads.
[Para 47] FIGURE 1 3 is a schematic illustration of bipolar AIMD leads wherein a bandstop filter is disposed between the leads to form a diverter circuit.
[Para 48] FIGURE 14 is a perspective view of a hermetically sealed L-C bandstop filter assembly embodying the present invention.
[Para 49] FIGURE 1 5 is an illustration of how small the hermetically sealed assembly of FIG. 1 4 is in comparison with a U. S. one-cent coin.
[Para 50] FIGURE 1 6 is a cross-sectional view taken generally along the line
1 6-1 6 from FIG. 1 4.
[Para 51 ] FIGURE 1 7 is a perspective view of a hermetic terminal shown in
FIGS. 14 and 1 6.
[Para 52] FIGURE 1 8 is a sectional view of the hermetic terminal taken generally along the line 1 8-1 8 from FIG. 1 6.
[Para 53] FIGURE 1 9 is an elevational view taken generally along the line 1 9-
1 9 from FIG. 1 6.
[Para 54] FIGURE 20 is a perspective view illustrating a multilayer flex cable onto which a chip capacitor and a chip inductor are mounted in accordance with the present invention.
[Para 55] FIGURE 21 is an electrical/physical schematic of the bandstop filter assembly of FIGS. 1 6 and 20, illustrating non-preferred conductive pathways and electrical connections to the serially arranged capacitor and inductor.
[Para 56] FIGURE 22 is a purely electrical schematic of the bandstop filter of
FIGS. 1 6 and 20.
[Para 57] FIGURE 23 is a perspective view of an alternative construction of the bandstop filter wherein the chip inductor and chip capacitor are mounted on a flexible circuit substrate.
[Para 58] FIGURE 24 is a perspective view of the assembly of FIG. 23, wherein the circuit substrate is folded up for insertion into a protective housing or container.
[Para 59] FIGURE 25 is a top plan view of another alternative embodiment, wherein the serial inductor and capacitor are electrically connected in parallel in accordance with the non-preferred method shown in FIG. 21 , and wherein an electrical insulator is disposed between adjacent ends of the inductor and the capacitor.
[Para 60] FIGURE 26 illustrates yet another embodiment, wherein the serial capacitor and inductor are situated on opposite sides of an intermediate substrate.
[Para 61 ] FIGURE 27 is an exploded perspective view of the bandstop filter assembly of FIGS. 1 6 and 20, illustrating a preferred arrangement for electrically connecting the inductor and capacitor in parallel while they are physically arranged in series.
[Para 62] FIGURE 28 is an electrical/physical schematic similar to FIG. 21 , illustrating preferred conductor pathways and electrical connections to the serially arranged capacitor and inductor shown in FIG. 27.
[Para 63] FIGURE 29 illustrates another embodiment where two bandstop filters are placed in series with one another within a hermetically sealed container.
[Para 64] FIGURE 30 is a purely electrical schematic of the dual bandstop filter assembly of FIG. 29.
[Para 65] FIGURE 31 is an electrical/physical schematic similar to FIGS. 21 and 28, illustrating preferred conductive pathways and electrical connections for the dual bandstop filter assembly of FIGS. 29 and 30.
[Para 66] FIGURE 32 is a perspective sectional view illustrating yet another embodiment where three inductors are physically placed in series with a single capacitor and yet electrically connected to the capacitor in parallel.
[Para 67] FIGURE 33 is an electrical/physical schematic diagram of the connections between the inductors and the capacitors of FIG. 32.
[Para 68] FIGURE 34 is a purely electrical schematic of the assembly of FIGS.
32 and 33.
[Para 69] FIGURE 35 is an exploded perspective view of the assembly of FIG.
32.
[Para 70] FIGURE 36 is an electrical/physical schematic diagram similar to
FIG. 33, but illustrating three inductors and a single capacitor all electrically conducted in parallel.
[Para 71 ] FIGURE 37 is a purely electrical schematic of the assembly of
FIG.36.
[Para 72] FIGURE 38 is an electrical/physical schematic diagram similar to
FIGS. 33 and 36, but illustrating two capacitors and a single inductor all electrically connected in parallel.
[Para 73] FIGURE 39 are equivalent electrical schematics for the assembly of
FIG. 38.
[Para 74] FIGURE 40 is an electrical/physical schematic diagram similar to
FIG. 38, but illustrating two capacitors electrically connected in series, and then collectively electrically connected in parallel with a single inductor.
[Para 75] FIGURE 41 are equivalent electrical schematics for the assembly of
FIG. 40.
[Para 76] FIGURE 42 is a fragmented perspective view of a passive electrode typically used in cardiac pacemaker applications.
[Para 77] FIGURE 43 is a fragmented perspective view of an active fixation tip.
[Para 78] FIGURE 44 is an enlarged, fragmented sectional view taken generally along the line 44-44 from FIG. 43, illustrating placement of a bandstop filter in accordance with the present invention in series with an electrical lead for a medical device.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [Para 79] As shown in the accompanying drawings for purposes of illustration, the present invention is directed to miniature inductor and chip components which are physically arranged in series, but electrically connected to one another in parallel to form tank circuits and bandstop filters for impeding or diverting currents induced by electromagnetic interference, for example, in a lead or an electrode of a medical device. Such bandstop filters may be placed electrically in series with an implanted lead or electrode of an active implantable medical device (AIMD), and in a variety of other electronics circuits used in commercial electronics, military, aerospace or other applications, where it may serve as an impeder at certain resonant frequencies. The bandstop filter of the present invention may also be placed electrically in parallel between leads or circuit traces where it may serve as a RF current diverter at the resonant frequency.
[Para 80] FIGURE 1 is a wire formed diagram of a generic human body showing a number of active implantable and external medical devices 1 00 that are currently in use. 10OA represents a family of hearing devices which can include the group of cochlear implants, piezoelectric sound bridge transducers
and the like. 1 0OB represents a variety of neurostimulators and brain stimulators. Neurostimulators are used to stimulate the Vagus nerve, for example, to treat epilepsy, obesity and depression. Brain stimulators are pacemaker-like devices and include electrodes implanted deep into the brain for sensing the onset of the seizure and also providing electrical stimulation to brain tissue to prevent the seizure from actually occurring. The leads associated with a deep brain stimulator are often placed using real time MRI imaging. Most commonly such leads are placed during real time MRI. I OOC shows a cardiac pacemaker which is well-known in the art. 1 0OD includes the family of left ventricular assist devices (LVAD's), and artificial hearts, including the recently introduced artificial heart known as the Abiocor. 1 0OE includes an entire family of drug pumps which can be used for dispensing of insulin, chemotherapy drugs, pain medications and the like. Insulin pumps are evolving from passive devices to ones that have sensors and closed loop systems. That is, real time monitoring of blood sugar levels will occur. These devices tend to be more sensitive to EMI than passive pumps that have no sense circuitry or externally implanted leadwires. 10OF includes a variety of bone growth stimulators for rapid healing of fractures. I OOG includes urinary incontinence devices. 1 0OH includes the family of pain relief spinal cord stimulators and anti-tremor stimulators. 10OH also includes an entire family of other types of neurostimulators used to block pain. 1 001 includes a family of implantable cardioverter defibrillators (ICD) devices and also includes the family of congestive heart failure devices (CHF). This is also known in the art as cardio
resynchronization therapy devices, otherwise known as CRT devices. 1 0OJ illustrates an externally worn pack. This pack could be an external insulin pump, an external drug pump, an external neurostimulator or even a ventricular assist device. 1 0OK illustrates the insertion of an external probe or catheter. These probes can be inserted into the femoral artery, for example, or in any other number of locations in the human body. 10OL illustrates one of various types of EKG/ECG external skin electrodes which can be placed at various locations. I OOM are external EEG electrodes placed on the head. [Para 81 ] FIGURES 2 and 3 are drawings of a typical cardiac pacemaker 10OC showing a titanium case or housing 102 and an IS-I header connector block
I 04. The titanium case or housing 1 02 is hermetically sealed, however there is a point where leadwires 1 06 must ingress and egress a hermetic seal. This is accomplished by providing a hermetic terminal assembly 1 08 that generally consists of a ferrule 1 1 0 which is laser welded to the titanium housing 1 02 of the AIMD 1 0OC.
[Para 82] Referring to FIG. 3, four leadwires are shown consisting of leadwire pair 1 06a and 1 06b and leadwire pair 1 06c and 1 06d. This is typical of what is known as a dual chamber bipolar cardiac pacemaker. The IS-I connectors 1 1 2 and 1 1 2' of leads 1 1 4 and 1 14' are designed to plug into receptacles 1 1 6 and
I 1 6' in the header block 104. The receptacles 1 1 6 and 1 1 6' are low voltage (pacemaker) connectors covered by an ANSI/AAMI ISO standard IS-I . Higher voltage devices, such as implantable cardioverter defibrillators (ICDs), are covered by ANSI/AAMI ISO standard DF-I . A new standard which will integrate
both high voltage and low voltage connectors into a miniature in-line quadripolar connector is known as the IS-4 series. The implanted leads 1 14 and 1 14' are typically routed in a pacemaker application down into the right atrium 1 1 8 and the right ventricle 1 1 8' of the heart 1 20. New generation biventricular devices may introduce leads to the outside of the left ventricle, which devices have proven to be very effective in cardiac resynchronization and treating congestive heart failure (CHF).
[Para 83] An RF telemetry pin antenna 1 22 is also shown which is not electrically connected to the leadwires 106 or the receptacles 1 1 6. The RF telemetry pin antenna 1 22 acts as a short stub antenna for picking up telemetry (programming) signals that are transmitted from the outside of the device l OOC.
[Para 84] Although the present invention will be described herein in the context and environment of a cardiac pacemaker 1 0OC and its associated leads 1 14, the present invention may also be advantageously utilized in many other types of AIMDs as briefly outlined above, as well as in other commercial electronic, military, aerospace and other applications. In the following discussion, to the extent practicable, functionally equivalent components will retain the same or a similar (in increments of 1 00) reference number, irrespective of the particular embodiment being described. [Para 85] FIGURE 4 illustrates a prior art single chamber bipolar device 10OC and lead system 1 1 4 and 1 14' with a distal Tip electrode 1 24 and a Ring electrode 1 26 typically as used with the cardiac pacemaker 10OC. Should the
patient be exposed to the fields of an MRI scanner or other powerful emitter used during a medical diagnostic procedure, currents that are directly induced in the lead system 1 14 can cause heating by I2R losses in the lead system or by heating caused by RF current flowing from the Tip and Ring electrodes 1 24, 1 26 into body tissue. If these induced RF currents become excessive, the associated heating can cause damage or even destructive ablation to body tissue.
[Para 86] FIGURE 5 illustrates a single chamber bipolar cardiac pacemaker 1 0OC, and leads 1 14 and 1 1 41 having distal Tip 1 24 and distal Ring 1 26 electrodes. This is a spiral wound (coaxial) system where the Ring coil 1 1 4' is wrapped around the Tip coil 1 14. There are other types of pacemaker leadwire systems in which these two leads lay parallel to one another (known as a bifilar lead system), which are not shown.
[Para 87] FIGURE 6 is an enlarged schematic illustration of the area "6-6" in FIG. 5. In the area of the distal Tip 1 24 and Ring 1 26 electrodes, bandstop filters 1 28 and 1 28' have been placed in series with each of the respective Ring and Tip circuits. The Ring circuit wire 1 14' has been drawn straight instead of coiled for simplicity. The bandstop filters 1 28 and 1 28' are tuned such that, at an MRI pulsed RF frequency, a high impedance will be presented thereby reducing or stopping the flow of undesirable MRI induced RF current from the electrodes 1 24 and 1 26 into body tissues.
[Para 88] The Tip electrode 1 24 is designed to be inserted into intimate contact with myocardial tissue. Over time it becomes encapsulated and fully
embedded or buried within such tissue. However, the Ring electrode 1 26 is designed to float within the blood pool, for example, in the ventricle 1 1 8' or atrium 1 1 8. With the constant blood perfusion, the Ring electrode 1 26 is somewhat cooled during medical diagnostic procedures, such as MRI. However, the Tip electrode 1 24, which is embedded in the myocardial tissue, is thermally insulated in comparison. Moreover, it can't always be assumed that a Ring electrode 1 26 that is floating in the blood pool will be adequately cooled by the flow of blood. There are certain types of patients that have cardiovascular diseases that lead to very low blood flow rates and perfusion issues. The Ring electrode 1 26 can also become encapsulated by body tissues. Accordingly, both the distal Tip electrode 1 24 and the Ring electrode 1 26 are preferably both associated with bandstop filters 1 28 and 1 28'. However, since the operation of the bandstop filter 1 28 is more important with the Tip electrode 1 24 than it is with the Ring electrode 1 26 in order to prevent distal tip heating and associated tissue damage, in many cardiac applications only a Tip bandstop filter 1 28 may be required for MRI compatibility.
[Para 89] FIGURE 7 is a cross-sectional view of a generic prior art active fixation distal tip 1 30 which is typically used in conjunction with cardiac pacemakers. There is a metallic housing 1 32 which contains a sharp tipped distal helix coil 1 34. This helix coil 1 34 is shown in its retracted position, which enables the physician to insert the fixation tip assembly 1 30 endocardially through the venous system, through the atrium, and through the tricuspid valve into the right ventricle so it does not snag or tear any tissue,
and is designed to be extended and screwed into myocardial tissue. . Once it is in the appropriate position, the physician then turns leadwire spline assembly 1 36 in a clockwise rotation. This is done outside the pectoral pocket with the lead 1 1 4 protruding from the body. A torque tool is generally applied so that the physician can twist or screw the helix coil 1 34 into place. Protrusion 1 38 acts as a gear so that as helix coil 1 34 is turned, it is screwed forward. This makes for a very reliable fixation into myocardial tissue. The helix coil 1 34 is generally attached by a laser weld 140 to an end of the spline assembly 1 36 as shown. Attached to spline assembly 1 36, usually by laser welding, is the lead 1 14 coming from the AIMD. An optional feature 142 is placed on spline assembly 1 36 to create a positive stop as the physician is turning the leadwire assembly and screwing the helix coil 1 34 into body tissue. Of course, all of the materials of the active fixation tip 1 30 shown in FIG. 7 are biocompatible. Typically, the helix coil 1 34 is made of platinum iridium alloy and would be coated with various materials to improve electrical performance. The housing 1 32 would generally be composed of titanium or another equivalent biocompatible alloy. The spline 1 36 is generally a platinum iridium alloy. [Para 90] FIGURE 8 is the schematic diagram of a distal tip bandstop filter circuit 1 28 that can be inserted in series generally in location 144 in FIG. 7, as described in US 2007/01 1 2398 Al . In order to do this, it is usually important that the inductor element L 146(L) and the capacitor element 1 48(C) be hermetically enclosed and also mechanically protected. Accordingly, they are typically installed in a hermetically sealed mechanically robust enclosure.
However, these components must be very small in diameter to keep the lead and its associated distal tip small enough for insertion into various body tissues.
[Para 91 ] FIGURE 9 is a graph showing impedance versus frequency for the ideal parallel bandstop filter circuit 1 28 of FIG. 8. As one can see, using ideal (zero resistance) circuit components, the impedance measured between the lead 1 1 4 and the helix coil 1 34 is zero until one approaches the resonant frequency fr. At the frequency of resonance, these ideal components (the parallel inductor 146 and capacitor 1 48) combine together to approach an infinite impedance.
[Para 92] FIGURE 1 0 is a drawing of a generic unipolar AIMD 1 00 and lead 1 14, with the bandstop filter 1 28 added at or near the distal electrodel 34. The inductor 1 46 has a resistance element RL in series with it. The capacitor 1 48 also has a resistance Rc in series with it. The resistances RL and Rc can be separate discrete resistors or they are losses of the inductor and capacitor elements themselves. In general, the resistance RL will be the resistance of the circuit traces or wires used to form the inductor 146. The capacitor 148 has ohmic losses Rc due to the resistance of its internal electrode plates, connection to its electrode plates, and dielectric losses. In the capacitor industry this is known as the capacitor's equivalent series resistance or ESR. The bandstop filter circuit 1 28 illustrated in FIG. 1 0 is a "real" bandstop filter in that the resistive losses are included. This makes it distinct from the ideal bandstop filter circuit 1 28 shown in FIG. 8. The presence of the bandstop filter 1 28 will
present a very high impedance at a specific MRI RF pulse frequency to prevent currents from circulating through the distal electrode 1 34 into body tissue at this specific frequency.
[Para 93] FIGURE 1 1 is a family of curves 1 50, 1 52 and 1 54 which show the attenuation in dB versus frequency for the bandstop filters 1 28 of the present invention. Curve 1 50 represents the use of very high Q inductor and capacitor components. If the capacitor and the inductor were ideal, meaning that they would both have zero resistance, then there would be no 3 db bandwidth at all between points "a" and "b". However, since in the real world both the inductor and the capacitor do have losses, a 3 db bandwidth separation between points "a" and "b" is achieved. It is very important that there be suitable bandwidth for two reasons: one, the MRI machine has gradient fields which change the RF frequency. This is how the MRI machine selects a slice to image, for example, through the knee. It does this by modifying the 1 .5 Tesla or main static field by using a gradient field. This causes the Lamor frequency to change. Accordingly, one can see that some bandwidth is required centered around the specified pulsed resonant frequency of the MRI equipment so that all of these frequencies are properly attenuated in an implanted lead. If one were to deliberately use an inductor with a very high DC resistance and a capacitor with very high ESR, this would result in very low Q components and the resulting attenuation curve 1 52. The low Q attenuation curve 1 52 attenuates over a very broad range of frequencies; however, the attenuation in dB has been sacrificed.
[Para 94] Attenuation curves 1 54 or 1 56 shown in FIG. 1 1 are generally preferred. One can do this by controlling the relative Q of the inductor and the capacitor components of the bandstop filter 1 28. In one embodiment, the Q of the inductor would be relatively low and the Q of the capacitor would be relatively high. This means that the inductor would have a relatively high internal resistance and the capacitor would have a relatively low equivalent series resistance. This is achieved by using multiple turns of relatively small wire to create a high DC resistance in the inductor, and by using multiple and robust electrode plates to keep the equivalent series resistance (ESR) of the capacitor relatively low. The overall Q of the bandstop filter is thus selected to balance impedance at the selected frequency versus frequency bandwidth characteristics. The values of the inductor and the capacitor selected are such that the bandstop filter 1 28 is resonant at a selected frequency, and preferably selected to attenuate current flow through the lead or electrode along a range of selected frequencies. Such a frequency or range of frequency may include an MRI pulsed frequency. Typically, the Q of the inductor is relatively low or moderate, and the Q of the capacitor is relatively high or moderate to select the overall Q of the bandstop filter. That is, the inductor has a relatively high resistive loss RL, and the capacitor has a relatively low equivalent series resistance Rc.
[Para 95] FIGURE 1 2 illustrates a generic bipolar AIMD 1 00, meaning that it has two implanted leads 1 14 and 1 1 4'. Shown are multiple bandstop filters 1 28, 1 28' in series with each one of the leads 1 14 and 1 1 4'. For example, lead
1 14 has two bandstop filters 1 28 connected in series. As mentioned in US 2007/01 1 2398 Al , these could be designed to resonate at two different frequencies, thereby providing attenuation to the RF pulse fields of both 1 .5 Tesla and 3 Tesla MRI scanners. For example, the individual bandstop filters 1 28 in lead 1 1 4 could be designed to be resonant at 64 MHz (Fn) and 1 28 MHz (Fr2), respectively. This would have the desired effect of having a high impedance at both of these common MRI RF pulsed frequencies thereby providing a high level of attenuation to RF induced currents at both 1 .5 and 3.0T. There could also be additional bandstop filters 1 28 if needed. [Para 96] FIGURE 1 3 shows two circuit traces or leads 1 14 and 1 1 4', and the novel bandstop filter 1 28 of the present invention wired in parallel between the circuit traces or leads 1 14 and 1 1 4'. When the bandstop filter 1 28 is wired in parallel, instead of in series as shown FIGS. 6, 8, 1 0 and 1 2, the bandstop filter 1 28 becomes an RF current diverter instead of an RF current impeder. In FIG. 1 3, RF frequencies that form a voltage potential between circuit traces or leads 1 14 and 1 1 4' will all be diverted except at one frequency which is the resonant frequency of the bandstop filter 1 28. These types of circuits have broad utility in many types of radio applications or receiver applications, and many other types of electronic circuits used in the military, aerospace, and commercial markets.
[Para 97] As mentioned above, for medical implant applications it is very important that the implanted leads and their associated electrodes at the distal tips be very small. It is particularly important that the cross-sections or
diameters of the bandstop filters be very small for easy endocardial insertion into the venous system of the human body. The present invention meets these criteria by using a novel combination of components that are mechanically mounted in series, but whose lumped elements are electrically in parallel. The components generally consist of commercial off-the-shelf miniature chip capacitor and inductor components. These are generally manufactured in high volume throughout the world. Accordingly, they are very inexpensive, but more importantly, they are very small in size. By way of example, a few years ago a small sized monolithic chip capacitor (MLCC) would be 0603, meaning that it would be 0.060 inch long by 0.030 inch in width. In comparison, today inductor and capacitor chip components can be purchased as small as 0201 or 01005. This means that they are so small that they literally can fit through a pepper shaker. Human hands cannot possibly handle components this small. Accordingly, micro-robotic manufacturing is the preferred method of manufacturing the novel components assemblies of the present invention, wherein the components typically are delivered on tape and reel and fed into the robots which pick and place the components and then go through a series of steps including additional component placement, wave soldering, cleaning, automatic optical inspection and automated electrical testing. All of this is done in a linear robotic manufacturing operation that is completely or nearly free of human hands. In cardiac rhythm applications (pacemakers and ICDs), a desirable lead size is 6 French (.079 inches in diameter). For deep brain stimulator applications, an even smaller size is desirable, such as 3 French,
which is 1 millimeter in diameter or .039 inches. US 2007/01 1 2398 Al discloses a number of methods of manufacturing novel bandstop filters for placement in the lead systems of active implantable medical devices. The present invention extends these concepts further.
[Para 98] In mammalian implant applications, the bandstop filters of the present invention should be small and placed in series with the implanted lead or electrode of the medical device. In such applications, it is necessary that the bandstop filter itself or a container therefor be biocompatible and highly reliable. Although commercial off-the-shelf capacitor and inductor components are very small in size, arranging them such that they are electrically coupled and likewise physically placed in parallel can increase the size of the bandstop filter where complications can arise in the placement and use of the implanted lead or electrode.
[Para 99] Commercial off-the-shelf capacitor and inductor components are typically not comprised of biocompatible materials.
[Para 100] However, in accordance with the present invention, the inductor and capacitor elements can be constructed to be completely biocompatible. In this case it would be not necessary to place them in a biocompatible hermetic container. This would have great advantages in further reducing both size and cost. In this regard, US 2009-01 1 61 67, published May 7, 2009, and US 2009- 0259265, published October 1 5, 2009, are herein incorporated by reference. [Para 101 ] With reference to FIGURE. 14, it is a feature of the present invention that custom or "off-the-shelf" non-biocompatible miniature inductorl 46 and
capacitor 1 48 components are mechanically installed in hermetic packages or containers 1 56 in series, but have electrical circuit traces that couple the lumped inductor and capacitor elements electronically in parallel, thereby forming bandstop filters 1 28 as described above. FIG. 14 illustrates an hermetically sealed container 1 56 having the inductor (L) and capacitor (C) components installed therein in series with one another, but whose lumped L and C elements are coupled electronically in parallel, so as to form one or more bandstop filters. The hermetically sealed containerl 56 is very small in diameter or cross-section and can be disposed between portions of an implantable lead 1 14, within an electrode assembly, etc. FIGURE. 1 5 shows the exemplary hermetically sealed container 1 56 adjacent to a United States penny or one- cent coin 1 58.
[Para 102] FIGURE. 1 6 is a cross-sectional view taken generally along line 1 6- 1 6 of FIG. 1 4 and shows the various component parts of the hermetically sealed container 1 56. The container 1 56 comprises a housing 1 60 which is biocompatible. By way of example, the housing 1 60 can be comprised of a biocompatible metal or alloy, such as titanium, platinum, platinum-iridium, gold, silver, etc., or a non-metallic material such as sapphire, ruby, alumina, ceramic, etc. The inductor 1 46 and the capacitor 148 are disposed on a substrate 1 62 and physically arranged in series, or end-to-end, with one another yet conductively or electronically coupled to one another in parallel. Circuit traces 1 64 and 1 66 are conductively coupled to the inductor 146 and capacitor 1 48 of the bandstop filter 1 28 and extend to conductive terminals
1 68 and 1 70 of hermetic seal assemblies 1 72 and 1 74. The conductive terminals 1 68 and 1 70 are designed to be conductively coupled to portions of the implantable lead 1 1 4 or electrode assembly, and that any conductive members which can be conductively coupled to the bandstop filter 1 28 within container 1 56 and extend therethrough in a hermetic fashion could be used. [Para 103] FIGURE 1 7 is an enlarged perspective view of the hermetic seal assembly 1 74, having the terminal 1 70 extending therethrough to a crimp, solder joint or laser weld tip 1 76. The electrical connection to the tip 1 76 could also be formed by thermal-setting conductive adhesives. The terminal 1 70 is attached to an insulator 1 78, which is in turn attached to an outer ferrule 1 80. [Para 104] FIGURE 1 8 is a cross-section drawing taken along line 1 8-1 8 from FIG. 1 6. The terminal 1 70 is preferably of a common platinum-iridium alloy, such as 901 0 or 8020. However, any biocompatible and suitable material could be used in place of platinum-iridium. Gold braze 1 82 forms a hermetic seal between terminal 1 70 and insulator 1 78. The insulator 1 78 may be a polished sapphire, ruby, polycrystalline alumina, or even glass or a general ceramic material. Sputtering would first be deposited on the surfaces so that the gold braze 1 82 will readily adhere and wet. Gold braze 1 84 forms a hermetic seal between insulator 1 78 and the ferrule 1 80. Gold brazes 1 82 and 1 84 are generally pure gold brazes for biocompatibility and long term reliability. The surface preparation process for the ceramic insulator 1 78 can be as follows: C- Axis single crystal, polycrystalline alumina (Al 203), Zirconia Stabilized Alumina and/or Yttria Tetragonal Zirconia Polycrystalline YTZP is etched using RF plasma
before PVD sputtering using a biologically compatible metallic system. Plasma cleaning removes organic surface contamination and hydroxyl/oxides resulting in a higher energy surface. This activated surface readily forms strong covalent bonds with metallization atoms promoting robust, hermetic adhesion. Through industry standard process refinements, the resulting low stress, dense coating does not spall off or blister and improves the function and reliability of the final brazed joint. The outer ferrule 1 80 is also, preferably, of platinum-iridium since it's very easy to laser weld. It is also radio-opaque. [Para 105] In the preferred embodiment, the insulator 1 78 would be a polished sapphire. It would then go through a plasma-etch process, such as a 500 watt plasma-etch, to increase its surface roughness. Titanium lignum metallization would be a preferred sputter material for adhesion and wetting of the associated gold braze pre-forms.
[Para 106] In FIG. 1 7, one can see that the interior tip 1 76 of the terminals 1 68 and 1 70 has been extruded to be fitted into an aperture, socket, etc. of the conductive substrate or circuit traces 1 64 and 1 66. Alternatively, the interior tip 1 76 may have an aperture therethrough so that a crimped connection can be formed between it and the conductive substrate or circuit traces 1 64 and 1 66, and subsequently laser welded. The method of attachment to the interior tip 1 76 will vary in accordance with the type of attachment desired to the internal circuitry of the bandstop filter 1 28. In any event, the conductive terminals 1 68 and 1 70 are conductively coupled to the bandstop filter 1 28 as the associated hermetic seal assemblies 1 72 and 1 74 are slid into place and
hermetically sealed by laser welding 1 86 to the housing 1 60 of the container 1 56.
[Para 107] FIG. 1 6 shows the bandstop filter 1 28 comprised of the inductor 1 46 and capacitor 1 48, and the flexible circuit substrates 1 64 and 1 66 extending therefrom, attached to the terminals 1 68 and 1 70 so as to place the terminals 1 68 and 1 70 in electrical series with one another. However, the inductor 1 46 and the capacitor 1 48, although placed end-to-end and physically in series with one another, are conductively coupled electrically with one another in parallel. An insulating material 1 88, such as a thermal-setting non- conductive polymer, at least partially fills the remainder of the housing 1 60 to provide protection and mechanical robustness to the overall container assembly 1 56. This structure lends itself to a novel "ship-in-the-bottle" method of manufacturing. That is, all of the elements contained within the housing 1 60 are pre-assembled outside the housing. In particular, the terminal 1 68, the substrate 1 62 containing the inductor 146 and capacitor 148, and the opposite terminal 1 70 and the associated hermetic seals 1 72 and 1 74, are all pre- assembled outside of the overall housing 1 60. This facilitates proper electrical connections and electrical testing of the pre-assembly. In addition, this entire subassembly can go through high reliability screening. Typically, this would consist of thermal cycling or thermal shock followed by a burn-in, which means applying a relatively high voltage at elevated temperature to the circuit components and then exhaustive electrical test afterwards. Once all of this has
been done, this entire pre-assembly is slipped inside the overall cylindrical housing 1 60 and then a final laser weld 1 86 is formed. [Para 108] FIGURES 1 6 and 1 9 also show an optional conformal coating 1 90 which is provided over the two gold brazes 1 82 and 1 84. This conformal coating 1 90 could also be applied to the entire outer surface of the housing 1 60 and a portion of terminals 1 68 and 1 70, as well as optionally over the electrical attachments to the lead system. This conformal coating 1 90 is important to provide electrical isolation between the two terminals 1 68 and 1 70. When directly exposed to body fluids (which contain electrolytes), gold can migrate in the presence of a voltage bias. It has been shown that pacemaker pacing pulses in saline solution can actually cause a gold electromigration or electroplating action. The concern is that the gold braze materials 1 82 and/or 1 84, under voltage or pulse bias, may over time migrate or deposit (electroplate) onto another surface such as the terminal 1 70 or the housing 1 60, which could negatively affect the long-term hermeticity and reliability of the hermetic seal assembly 1 74. Accordingly, the conformal coating or backfill 1 90 is placed as shown to cover both of the gold brazes 1 82 and 1 84. The conformal coating 1 90 may comprise thermal-setting non-conductive adhesives, silicones, parylene (which is vapor deposited), and the like, including epoxies, polyimides, polyethylene oxide, polyurethane, silicone, polyesters, polycarbonate, polyethylene, polyvinyl chloride, polypropylene, methylacrylate, para-xylylene, and polypyrrhol. In particular, Epo-tek H81 is considered a preferred epoxy which has already been tested for long-term biocompatibility.
[Para 109] A complete conformal coating 1 90 over the entire housing 1 60 may be desirable to provide electrical isolation between the conductive terminal pins 1 68 and 1 70. This provides critical performance capability in the event of complete saturation of the housing 1 60 in saline or biological fluid. Additional performance benefits for a conformal coating 1 90 include lubricity, radiopacity, and wear resistance.
[Para 1 10] FIGURE. 20 illustrates a multi-layer flex cable 1 92 onto which the inductor 1 46 and capacitor 148 are mounted. The inductor 146 is a chip inductor having first and second conductive termination surfaces 1 94 and 1 96 which are spaced from one another in non-conductive relation. The capacitor 1 48 also has first and second conductive termination surfaces 1 98 and 200 which are spaced apart from one another in non-conductive relation. The chip inductor 1 46 can be any number of chip inductor types, however the present invention is also not limited to chip inductors only. The inductor 146 could also be a solenoid inductor, a toroidal inductor, or any type of inductor that is known in the prior art. Moreover, the chip capacitor 1 48 can be any number of chip capacitor types, but the present invention is not limited to chip capacitors only. The capacitor 1 48 may be of many different types of capacitor technologies, including film capacitors, tantalum capacitors, monolithic ceramic capacitors, electrolytic capacitors, feedthrough-type capacitors, or even tubular capacitors. FIG. 20 shows that the inductor 1 46 and the capacitor 1 48 are physically disposed in series relative to one another, such that they are generally aligned with one another along a common longitudinal axis and
placed end-to-end. However, in accordance with the present invention, the inductor 1 46 and the capacitor 1 48 are conductively or electrically coupled to one another in parallel. FIGURE 22 is an electrical schematic diagram of the bandstop filter of FIGS. 20 and 21 . When electrically connected as shown in FIG. 21 , the second conductive terminal 1 96 of the inductor 146 is spaced a suitable distance away from the first conductive terminal 1 98 of the capacitor 1 48. The reason that these termination surfaces 1 96 and 1 98 must be placed apart is that in the presence of an MRI scanner, a substantial RF voltage can be generated across this gap. Arching or even short circuits may undesirably occur. Another concern is that a long term failure may occur due to the formation of metal dendrites or whiskers. This can happen even in the presence of a low voltage bias. However, having a large physical gap between the termination surfaces 1 96 and 1 98 is generally undesirable because it increases the overall length of the bandstop filter 1 28. As previously mentioned, the most critical dimension is the diameter. However, it is also important that the overall assembly not get too long. [Para 1 1 1 ] FIGURE 20 may be compared with FIG. 1 6 to see alternative configurations of the attachment between conductive terminals 1 68 and 1 70, and the conductive circuit traces or electrodes in 1 64 and 1 66. FIG. 1 6. illustrates a crimp configuration between the circuit traces or conductive substrates 1 64 and 1 66, and the respective tips 1 76 of the conductive terminals 1 68 and 1 70. In FIG. 20, an alternative configuration is shown wherein the hermetic seal assemblies 1 72 and 1 74 are pre-mounted to the
conductive circuit traces or substrates 1 64 and 1 66, and attached thereto by resistance welding or the like.
[Para 1 12] FIGURE 23 illustrates an alternative embodiment wherein a flexible circuit substrate 202 is shown. For robotic manufacturing, it is highly desirable if the circuit substrate 202 be laying flat while the pick and place robots place the inductor 146 and the capacitor 148 components. The circuit substrate 202 includes portions which are conductive and other portions which are non- conductive, such that the conductive portions or traces of the substrate 202 place the inductor 146 and capacitor 1 48 in parallel electrical connection, although the inductor 146 and capacitor 1 48 are disposed generally end-to- end physically in series with one another. As illustrated in FIG. 24, the substrate 202 is then folded up so that it will fit conveniently into the cylindrical housing 1 60 as previously illustrated in FIG. 1 6. [Para 1 1 3] FIGURE 25 shows another arrangement for an inductor 146 and a capacitor 1 48 physically disposed in series with one another in that they are arranged physically generally end-to-end, and yet the inductor 1 46 and the capacitor 1 48 are electrically connected in parallel to form a bandstop filter 1 28. A first conductive substrate or circuit trace 1 64 conductively couples the first conductive terminals 1 94 and 1 98 of the inductor 1 46 and the capacitor 1 48. An insulator 204 prevents conductive contact between the conductive substrate circuit trace 1 64 and the second conductive termination surface 1 96 of the inductor 1 46. Similarly, a conductive substrate or circuit trace 1 66 is conductively coupled to and extends between the second conductive
termination surface 1 96 of the inductor 1 46 and the second conductive termination surface 200 of the capacitor 1 48. Another insulative layer 206 is disposed adjacent to the circuit trace or substrate 1 66 to prevent electrical contact between the first conductive termination surface 1 98 of the capacitor and the circuit trace or substrate 1 66. Conductive coupling can be by any known means, including solders or brazes. An insulator or insulating material is disposed between adjacent ends of the inductor 1 46 and the capacitor 1 48 to prevent arching or short circuits from developing between the adjacent conductive termination surfaces in the presence of, for example, an MRI scanner wherein a substantial RF voltage can be generated across this gap. The physical/electrical schematic model for the embodiment shown in FIG. 25 is illustrated in FIG. 21 .
[Para 1 14] FIGURE 26 illustrates an alternative embodiment wherein the inductor 1 46 and the capacitor 1 48 are disposed on generally opposite first and second surfaces of a non-conductive substrate 206. Nonetheless, the inductor 1 46 and the capacitor 1 48 are generally arranged end-to-end and in series with one another. They are merely placed on opposite sides of the non- conductive substrate 206. A conductive substrate or circuit trace 1 64' extends from the first conductive terminal 1 98 of the capacitor 148 and is conductively coupled to a circuit trace 1 64 extending from the first conductive terminal 1 94 of the inductor 146 by means of a conductive connection through a passageway or through hole 208 extending through the non-conductive substrate 206. Similarly, a conductive substrate or circuit trace 1 66' extends from the second
conductive terminal 1 96 of the inductor 1 46 across the non-conductive substrate 206 and is placed in conductive relation with the second conductive terminal 200 of the capacitor 148, such as by means of the conductive passage 210 which interconnects the circuit trace 1 66' with the circuit trace 1 66. The ends of circuit traces 1 64 and 1 66 can be coupled in series to the desired lead, electrode assembly, etc.
[Para 1 1 5] It will be appreciated that all of the assemblies illustrated in FIGS. 20-41 may be placed within a hermetically sealed container or package 1 56 so that off-the-shelf non-biocompatible inductor and capacitor components may be used. As such, conductive substrates, circuit traces or the like extending from the bandstop filter 1 28 will be conductively coupled to conductive contacts, such as terminals 1 68 and 1 70, extending through the housing 1 60 of the hermetically sealed assembly. In this manner, the hermetically sealed container 1 56 can be physically disposed in series between first and second portions of a lead or an electrode so as to place the bandstop filter 1 28 in series therewith.
[Para 1 16] FIGURES 27 and 28 are similar to FIGS. 20 and 21 , but illustrate the preferred manner of electrically attaching the inductor 1 46 and the capacitor 1 48 in parallel while simultaneously arranging them physically in series, in accordance with the present invention. FIG. 27 differs from FIG. 20 in that the conductive circuit traces or substrates 1 64 and 1 66 are shown with much of the insulative and overmolding material of the substrate or flex cable 1 92 (FIG. 20) removed. Notably, the arrangement of components illustrated in FIGS. 27 and
28 requires no space between the inductor 1 46 and the capacitor 1 48, thus minimizing the longitudinal dimensions of the bandstop filter 1 28. [Para 1 1 7] As seen best in FIGURE 27, the second termination surface 1 96 of the inductor 146 is electrically shorted or at the same potential as the first termination surface 1 98 of the capacitor 1 48. By having a zero or nearly zero potential, there is no chance that arching, shorting or dendritic growth between these opposed surfaces 1 96 and 1 98. This also eliminates a space or gap between the inductor 1 46 and the capacitor 148. As shown in FIG. 27, a conductive bonding pad 214 is coupled to the conductive substrate 1 66 and conductively coupled to the second conductive terminal 200 of the capacitor 1 48. An insulative layer 21 6 extends between the circuit substrates 1 66 and 1 64. A conductive pad 21 8 comes into contact with conductive terminals 1 96 and 1 98 of the inductor 1 46 and the capacitor 1 48. Conductive passthroughs 220 extend from the conductive pad 21 8 through the insulative layer 21 6 and to the conductive circuit substrate 1 66 so as to place the conductive terminals 1 96 and 1 98 in conductive relation with each other and with the circuit trace or substrate 1 64. Similarly, a non-conductive insulation layer 222 extends between circuit substrates 1 64 and 1 66 and has a conductive pad 224 on an upper surface thereof which communicates with a conductive through hole 226 to the conductive substrate 1 64, so as to place the first conductive terminal 1 94 of the inductor 146 in conductive relation and connection with the circuit substrate 1 66.
[Para 1 18] This arrangement is diagrammatically illustrated the physical/electrical schematic of FIG. 28, wherein the capacitor 1 48 and inductor 1 46 are disposed physically in series with one another, but electrically and conductively coupled to one another in parallel. However, the entire bandstop filter, comprised of the capacitor 1 48 and the inductor 146 is in series with terminals Ti and T2, which could comprise the ends of the conductive substrates or circuit traces 1 64 and 1 66, the terminals 1 68 and 1 70, etc., so as to place the overall assembly in series with the implantable lead or electrode of a medical device. By carefully tracing each circuit, one can see that the inductor 1 46 ends up in parallel with the capacitor 148, forming a parallel resonant L-C bandstop filter 1 28, as illustrated in the electrical schematic drawing of FIG. 22. [Para 1 19] There are particular challenges to designing and assembling components this small. Placing them in a hermetic package is even more challenging. In the present invention, a pre-assembly or subassembly may comprise the circuit traces, the inductor 1 46 and the capacitor 1 48 components, and the electrical connections. Then the hermetic seal assemblies 1 72 and 1 74 are attached to both ends of this rigid or flexible pre-assembly. This entire assembly is slid into a metallic tube or housing 1 60 (typically platinum or titanium), and then relatively low energy laser welds are used to make the final hermetic seal. The laser welds generally involve a spot size of 0.005 inches, which limits the amount of heating that's involved. This guarantees that the sensitive internal electrical connections and components will not be damaged.
[Para 120] FIGURES 29-31 illustrate a configuration where two bandstop filters 1 28 and 1 28' are placed in series. The first bandstop filter 1 28 consists of capacitor 1 48 and inductor 146. The second bandstop filter 1 28' consists of capacitor 248 and inductor 246. The first conductive substrate or circuit trace 1 64 cooperates with an intermediate internal circuit trace or conductive substrate (not shown) to conductively couple the capacitor 1 48 and the inductor 1 46 of the first bandstop filter 1 28 in parallel electrical relation with one another, and the second end circuit trace or conductive substrate 1 66 cooperates with the intermediate circuit trace or conductive substrate to place the capacitor 248 and the inductor 246 of the second bandstop filter 1 28' in parallel with one another such that the bandstop filters 1 28 and 1 28' are placed in series with one another. One can follow the conductive circuit paths within substrate 1 92 of each bandstop filter shown in FIG. 29, in the physical/electric schematic illustration of FIG. 31 .
[Para 121 ] In a preferred embodiment, the bandstop filters 1 28 and 1 28' will be resonant at two different selective frequencies. For example, the first bandstop filter 1 28 could have a self resonant frequency at 64 MHz which corresponds with a 1 .5 Tesla MRI machine. The second bandstop filter 1 28' could be resonant at 1 28 MHz which is the RF pulsed frequency of a 3 Tesla MRI system. Accordingly, by putting the two bandstop filters in series, the bandstop filter network of FIG. 29 would offer a high degree of attenuation to RF induced currents at both of these popular MRI frequencies.
[Para 122] However, the bandstop filters 1 28 and 1 28' can have the same resonant frequency or approximately the same resonant frequencies. The advantage of having two bandstop filters in series with approximately the same resonant frequency is that this increases the attenuation of the overall bandstop filter. By having the resonant frequencies of the bandstop filters 1 28 and 1 28' at slightly different frequencies, the resultant filter has the advantage of broadening the 3 dB bandwidth (see FIG. 1 1 ). An advantage of the configuration shown in FIG. 29 is that the slenderness ratio of the assembly can be maintained. That is, the overall diameter of the assembly must not be allowed to increase. Length is not nearly as critically important for an implantable lead, for example, for cardiac rhythm application, as is diameter. Also current handling ability is very important. By having two bandstop filters in series, one greatly increases the overall impedance and attenuation at resonance thereby providing a much higher level of protection to adjacent body tissues.
[Para 123] FIGURES 32-34 illustrate an alternative embodiment where three series inductors 146, 246 and 346 are placed in parallel with a single capacitor 1 48. It is well known in electrical engineering that when inductors are wired in series they add up. In other words, the total inductance is the sum of the three individual inductances. The three inductors 1 46, 246 and 346, which are in series are together in parallel with the capacitor 148, form the bandstop filter 1 28 as shown in FIG. 34. This arrangement has particular advantages for AIMD lead applications. This allows one to have a relatively high value of inductance
while at the same time keeping the diameter or cross-sectional area very small. A disadvantage of this arrangement is that the resistive losses of the three inductors add up in series. This makes the bandstop filter Q a little lower, tends to widen its 3 dB bandwidth, but also reduces its attenuation. The current handling ability, such as during an automatic external defibrillation pulse, is also slightly compromised by the added series resistance. Conversely the current handling ability and/or the bandstop filter Q can be improved by using a larger wire /trace /pathway diameter or width. The reduction on inductance per component, compared to an inductor with the same length utilizing a smaller wire/trace/pathway diameter or width, can be compensated by the increased number of inductors. Of course one will appreciate that the three series inductors can be replaced with two inductors, four inductors or more, all wired in series and then placed in parallel with the capacitor 148 to form a bandstop filter 1 28 having the desired characteristics. [Para 124] FIGURE 35 is an exploded perspective view of the electrical subassembly of FIG. 32. Here, one can see that it has the same circuit substrate 1 92 that was shown in FIG. 32, which includes an insulative layer 228. It will be appreciated that much of the insulation forming a portion of the circuit substrate 1 92 has been removed in FIG. 35 to better illustrate the electrical circuit traces or substrates which electrically connect the three inductors 146, 246 and 346 in series, and place them all electrically in parallel with the capacitor 1 48. In this regard, the conductive circuit trace or substrate 1 64 extends nearly the length of the entire subassembly so as to conductively
couple two both the first termination surface 1 94 of the first inductor 1 46 and to the second termination surface 200 of the capacitor 148. This is accomplished by providing a conductive pad 224a atop an insulation layer 222a, and a conductive passthrough 226a. The first conductive termination surface 1 94 of the first inductor 1 46 is conductively coupled to the conductive pad 224a which, in turn, conductively couples said first termination surface 1 94 to the substrate 1 64. In like manner, the second termination surface 200 is positioned adjacent and conductively coupled to a conductive pad 224e which sits atop an insulative layer 222e. The conductive pad 224e is conductively coupled to the substrate 1 64 through a conductive through-hole 226d. In order to place the three inductors 1 46, 246 and 246 electrically in series, two conductive pads 224b and 224c are provided which are electrically isolated from the underlying substrate 1 64 by insulative layers 222b and 222c. The second termination surface 1 96 of the first inductor 146 rests atop and is conductively coupled to the conductive pad 224b as is the first termination surface 294 of the second inductor 246. This arrangement conductively couples the second termination surface 1 96 of the first inductor 146 to the first termination surface 294 of the second inductor 246. Similarly, the second termination surface 296 of the second inductor 246 rests atop a conductive pad 224c and is conductively coupled thereto, as is the first termination surface 394 of the third inductor 346. This arrangement conductively couples the second termination surface 296 of the second inductor 246 to the first termination surface 394 of the third inductor 346. Finally, the second conductive
termination surface 396 of the third inductor 346 is conductively coupled to the first termination surface 1 98 of the capacitor 148 by means of a conductive pad 224d on which both termination surfaces rest and are conductively coupled thereto. This conductive pad 224d is situated atop an insulative layer 222d and is conductively coupled to the conductive circuit trace or substrate 1 66 by means of conductive through-holes or passageways 226b and 226c. [Para 125] FIGURES 36 and 37 illustrate yet another arrangement contemplated by the present invention, wherein the three inductors 1 46, 246 and 346 are placed in series with one another physically, but coupled conductively with one another in parallel. The capacitor 1 48 is also conductively coupled with the inductors 1 46, 246 and 346 in parallel to create a bandstop filter 1 28.
[Para 126] FIGURES 38 and 39 illustrate another arrangement contemplated by the present invention, wherein two capacitors 1 48 and 248 are placed in series with one another physically but coupled conductively with one another in parallel. The capacitors are also conductively coupled with the inductor 146 in series to create a bandstop filter 1 28. Yet another alternative is illustrated in FIGS. 40 and 41 , wherein the capacitors 1 48 and 248 are disposed physically in series with one another and conductively coupled to one another in series, yet conductively coupled to the inductor L in parallel to form a bandstop filter 1 28. In both of these latter two embodiments, the capacitors 1 48 and 248 and the inductor 1 46 are placed end-to-end and generally disposed in series with one another yet still form a bandstop filter without increasing the overall diameter
of the assembly. Thus, it will be appreciated that different values of the bandstop filter 1 28 may be obtained by placing multiple capacitors or inductors physically in series with one another, but in various combinations of electrical and parallel coupling to achieve the desired values.
[Para 127] With reference now to FIG. 42, a passive electrode 230 typically used in cardiac pacemaker applications is shown in which the hermetically sealed bandstop filter assembly of the present invention can be incorporated. FIG. 43 illustrates an active fixation Tip electrode 1 30 having a helix screw 1 34 selectively extendable and retractable from the lead housing 1 32. The helix screw 1 34 is retracted while the lead housing 1 32 is inserted endocardially to the correct location, for example, into the right ventricle. The physician then uses a tool (not shown) in the pectoral pocket and twists this entire assembly which literally screws the distal helix screw 1 34 into the myocardial tissue. [Para 128] FIGURE 44 is a cross-section taken along line 44-44 from FIG. 43. Shown is the hermetically sealed bandstop filter assembly 1 56 that is embedded within the overall lead housing 1 32. The hermetically sealed bandstop filter assembly 1 56 can be as the assembly illustrated in FIGS. 1 4 and 1 6, or any of the other variations illustrated herein or contemplated by the present invention. The important aspect is that the various inductor and capacitor components be physically disposed in series relative to one another, yet conductively coupled in parallel to form one or more bandstop filters which are hermetically sealed in a biocompatible container for insertion into the electrode or leadwire of the medical device.
[Para 129] Accordingly, from all of the foregoing it will be appreciated that the present invention relates to passive bandstop filter circuits wherein one or more of both inductor 146 and capacitor 1 48 elements are physically disposed in series but whose equivalent (lumped) L-C parameters are electrically connected in parallel. The disclosed embodiments are particularly suitable for applications where it is important to keep the diameter or cross-sectional area of the bandstop filter 1 28 relatively small as, for example, in medical implanted leads. Providing bandstop filters in such medical implanted leads serves to reduce the amount of radio frequency (RF) current associated heating due to energy deposited on the leads during medical diagnostic procedures, such as magnetic resonance imaging (MRI). The bandstop filter 1 28 may be designed to be resonant at the MRI RF pulsed frequency and thereby present a high impedance in the lead thus reducing RF current flow.
[Para 1 30] Although several embodiments have been described in detail for purposes of illustration, various modifications may be made without departing from the scope and spirit of the invention. Accordingly, the invention is not to be limited, except as by the appended claims.
Claims
What is claimed is: [Claim 1 ] A bandstop filter, comprising: an inductor having first and second conductive terminals in spaced non- conductive relation; and a capacitor having first and second conductive terminals in spaced non- conductive relation; wherein the inductor and the capacitor are physically disposed in series relative to one another; and wherein the inductor and the capacitor are electrically connected to one another in parallel.
[Claim 2] The bandstop filter of claim 1 , wherein one of the first or second conductive terminals of the inductor is disposed generally adjacent to one of the first or second conductive terminals of the capacitor.
[Claim 3] The bandstop filter of claim 2, wherein the capacitor and the inductor are aligned along a common axis.
[Claim 4] The bandstop filter of claim 2, wherein the adjacent conductive terminals of the inductor and the capacitor abut one another.
[Claim 5] The bandstop filter of claim 2, including an electrical insulator disposed between the adjacent conductive terminals of the inductor and the capacitor.
[Claim 6] The bandstop filter of claims 2 or 4, wherein electrical potential between the adjacent conductive terminals of the inductor and the capacitor is minimized.
[Claim 7] The bandstop filter of claim 6, wherein the electrical potential between the adjacent conductive terminals of the inductor and the capacitor is zero.
[Claim 8] The bandstop filter of claim 1 , wherein the inductor comprises a chip inductor.
[Claim 9] The bandstop filter of claim 1 , wherein the capacitor comprises a chip capacitor.
[Claim 1 0] The bandstop filter of claim 1 , wherein the second conductive terminal of the inductor is conductively coupled to the first conductive terminal of the capacitor, and wherein the first conductive terminal of the inductor is conductively coupled to the second conductive terminal of the capacitor.
[Claim 1 1 ] The bandstop filter of claim 1 , wherein the parallel capacitor and inductor are disposed in series in an electrical lead or circuit trace.
[Claim 1 2] The bandstop filter of claim 1 1 , wherein the capacitor and the inductor are tuned to impede induced current flow through the electrical lead at a selected frequency.
[Claim 1 3] The bandstop filter of claim 1 1 , wherein the electrical lead comprises an implanted lead.
[Claim 1 4] The bandstop filter of claim 1 3, wherein the electrical lead comprises at least a portion of a medical device.
[Claim 1 5] The bandstop filter of claim 1 4, wherein the electrical lead includes an active fixation tip, and wherein the bandstop filter is disposed within the active fixation tip.
[Claim 1 6] The bandstop filter of claim 1 , comprising a plurality of paired inductors and capacitors, wherein in each paired inductor and capacitor, the inductor and the capacitor are physically disposed in series relative to one another and the inductor and the capacitor are electrically connected to one another in parallel.
[Claim 1 7] The bandstop filter of claim 1 6, wherein each paired inductor and capacitor is electrically connected in series to another paired inductor and capacitor.
[Claim 1 8] The bandstop filter of claim 1 , wherein the parallel capacitor and inductor are disposed in parallel between two electrical leads or circuit traces.
[Claim 1 9] The bandstop filter of claim 1 8, wherein the capacitor and the inductor are tuned to divert induced current flow through the electrical leads except at a selected frequency.
[Claim 20] The bandstop filter of claim 1 , wherein the capacitor and the inductor comprise biocompatible and non-migratable materials.
[Claim 21 ] The bandstop filter of claim 1 , wherein the inductor comprises a plurality of inductors.
[Claim 22] The bandstop filter of claim 21 , wherein the plurality of inductors are conductively coupled to one another in series.
[Claim 23] The bandstop filter of claim 21 , wherein the plurality of inductors are conductively coupled to one another in parallel.
[Claim 24] The bandstop filter of claims 22 or 23, wherein the plurality of inductors are physically disposed in series relative to one another.
[Claim 25] The bandstop filter of claim 1 , wherein the capacitor comprises a plurality of capacitors.
[Claim 26] The bandstop filter of claim 25, wherein the plurality of capacitors are conductively coupled to one another in series.
[Claim 27] The bandstop filter of claim 25, wherein the plurality of capacitors are conductively coupled to one another in parallel.
[Claim 28] The bandstop filter of claims 26 or 27, wherein the plurality of capacitors are physically disposed in series relative to one another.
[Claim 29] The bandstop filter of claim 1 , including a hermetically sealed container in which the inductor and the capacitor are disposed.
[Claim 30] The bandstop filter of claim 24, wherein the hermetically sealed container comprises a biocompatible housing in which the bandstop filter is disposed, and biocompatible first and second conductive contacts extending through the housing and conductively coupled in series to the bandstop filter.
[Claim 31 ] The bandstop filter of claim 30, wherein the hermetically sealed container is disposed in series in an electrical lead.
[Claim 32] The bandstop filter of claim 31 , wherein the first and second contacts of the hermetically sealed container are connected to, respectively, first and second portions of the lead.
[Claim 33] The bandstop filter of claim 30, including a substrate onto which the inductor and the capacitor are fixed in a pre-assembly prior to insertion into the biocompatible housing.
[Claim 34] The bandstop filter of claim 33, wherein the pre-assembly is tested prior to insertion into the biocompatible housing.
[Claim 35] The bandstop filter of claim 34, including first and second hermetic terminals comprising at least a portion of the first and second conductive contacts, respectively.
[Claim 36] The bandstop filter of claim 35, wherein the hermetic terminals are hermetically sealed to the biocompatible housing after the pre-assembly is inserted therein.
[Claim 37] The bandstop filter of claim 1 , wherein the values of the inductor and the capacitor are selected such that the bandstop filter is resonant at a selected frequency.
[Claim 38] The bandstop filter of claim 37, wherein the overall Q of the bandstop filter is selected to balance impedance at the selected frequency versus frequency bandwidth characteristics.
[Claim 39] The bandstop filter of claim 38, wherein the Q of the inductor is relatively high, and the Q of the capacitor is relatively low.
[Claim 40] The bandstop filter of claim 39, wherein the inductor has a relatively low resistive loss, and wherein the capacitor has a relatively high equivalent series resistance.
[Claim 41 ] The bandstop filter of claim 38, wherein the Q of the inductor is relatively low, and the Q of the capacitor is relatively high.
[Claim 42] The bandstop filter of claim 41 , wherein the inductor has a relatively high resistive loss, and wherein the capacitor has a relatively low equivalent series resistance.
[Claim 43] The bandstop filter of claim 37, wherein the selected frequency comprises an MRI pulsed frequency.
[Claim 44] The bandstop filter of claim 37, wherein the overall Q of the bandstop filter is selected to attenuate current flow along a lead or circuit trace through a range of selected frequencies.
[Claim 45] The bandstop filter of claim 1 , wherein the inductor and the capacitor are mounted on a flexible circuit substrate.
[Claim 46] The bandstop filter of claim 45, wherein portions of the flexible circuit substrate are wrapped around the capacitor and the inductor.
[Claim 47] The bandstop filter of claim 46, wherein the wrapped capacitor and inductor assembly are disposed within a protective container.
[Claim 48] The bandstop filter of claim 47, wherein the protective container comprises a hermetically sealed protective container.
[Claim 49] The bandstop filter of claim 1 , wherein the inductor is disposed on a first surface of an intermediate substrate, and the capacitor is disposed on a second generally opposite surface of the intermediate substrate.
[Claim 50] The bandstop filter of claim 49, including circuit traces extending through the intermediate substrate and conductively coupling the inductor and the capacitor in parallel.
[Claim 51 ] The bandstop filter of claim 1 , wherein the inductor and the capacitor are robotically deposited on a substrate.
[Claim 52] The bandstop filter of claim 51 , wherein the substrate comprises a multilayer flex cable.
[Claim 53] The bandstop filter of claim 1 , wherein the inductor, the capacitor, and all associated electrical connections and support substrates, if any, comprise biocompatible materials to form a biocompatible package suitable for mammalian implantation.
[Claim 54] The bandstop filter of claim 29, including an electrically insulative conformal coating over at least a portion of the hermetically sealed container.
Priority Applications (1)
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EP09824060.9A EP2349453A4 (en) | 2008-10-30 | 2009-10-27 | Capacitor and inductor elements physically disposed in series whose lumped parameters are electrically connected in parallel to form a bandstop filter |
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US10967208P | 2008-10-30 | 2008-10-30 | |
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2010
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Also Published As
Publication number | Publication date |
---|---|
US8108042B1 (en) | 2012-01-31 |
EP2349453A1 (en) | 2011-08-03 |
US20100231327A1 (en) | 2010-09-16 |
EP2349453A4 (en) | 2015-07-01 |
US20100100164A1 (en) | 2010-04-22 |
US8175700B2 (en) | 2012-05-08 |
US20120035698A1 (en) | 2012-02-09 |
US7920916B2 (en) | 2011-04-05 |
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